In Vitro Susceptibility and Trailing Growth Effect of Clinical Isolates of Candida Species to Azole Drugs
Open accessAbstract
BACKGROUND: Emergence of resistance to respective antifungal drugs is a primary concern for the treatment of candidiasis. Hence, determining antifungal susceptibility of the isolated yeasts is of special importance for effective therapy. For this purpose, the clinical laboratory standard institute (CLSI) has introduced a broth microdilution method to determine minimum inhibitory concentration (MIC). However, the so-called "Trailing effect" phenomenon might sometimes pose ambiguity in the interpretation of the results. OBJECTIVES: The present study aimed to determine the in vitro susceptibility of clinical isolates of Candida against azoles and the frequency of the Trailing effect. MATERIALS AND METHODS: A total of 193 Candida isolates were prospectively collected and identified through the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Using a broth microdilution test, according to the guidelines of CLSI M27-A3, antifungal susceptibilities of the isolated yeasts against Fluconazole (FLU), Itraconazole (ITR), Ketoconazole (KET) and Voriconazole (VOR) were assessed. Moreover, trailing growth was determined when a susceptible MIC was incubated for 24 hours, and turned into a resistant one after 48 hours of incubation. RESULTS: Among the tested antifungal drugs in this study, the highest rate of resistance was observed against ITR (28.5%) followed by VOR (26.4%), FLU (20.8%) and KET (1.5%). The trailing effect was induced in 27 isolates (14.0%) by VOR, in 26 isolates (13.5%) by ITR, in 24 isolates (12.4%) by FLU, and in 19 isolates (9.8%) by KET. CONCLUSIONS: The monitoring of antifungal susceptibilities of Candida species isolated from clinical sources is highly recommended for the efficient management of patients. Moreover, the trailing effect should be taken into consideration once the interpretation of the results is intended.
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The trailing effect has been reported with azoles and Candida species.
“This effect has been reported with azoles and Candida species.65, 66, 67”
From Narrow mutational signatures drive acquisition of multidrug resistance in the fungal pathogen Candida glabrata (2021) · cites this paper as [65]
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- Authors
- Zomorodian, K., Bandegani, A., Mirhendi, H., Pakshir, K., Alinejhad, N., & Poostforoush Fard, A.
- Affiliations
- Shiraz University of Medical Sciences (IR)
- Venue
- Jundishapur Journal of Microbiology
- Publisher
- Brieflands
- Published
- 2016-02-20
- Volume
- 9
- Issue
- 2
- Pages
- e28666-e28666
- ISSN
- 2008-3645 (ISSN-L)
- 2008-4161
- PMC
- PMC4841996
- OpenAlex
- W2259440456
- Cited by
- 20
- References
- 55
- Citations by year
- 2026: 2 · 2025: 2 · 2023: 2 · 2021: 3 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 2 · 2016: 2
- FWCI
- 3.08
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- Jundishapur Journal of Microbiology (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- Funders
- Shiraz University of Medical Sciences
- Shiraz University
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
- Life Sciences › Agricultural and Biological Sciences › Ecology, Evolution, Behavior and Systematics › Fungal Plant Pathogen Control
- Keywords
- Candida, antifungal susceptibility, azole antifungals, fluconazole, itraconazole, ketoconazole, voriconazole, antifungal resistance, minimum inhibitory concentration, candidiasis, clinical isolates
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