Significance and Impact of the Study: The current study provides a detailed characterization of enzymatic activity, antifungal susceptibility, and genotypes of Candida glabrata recovered from urine or oral culture from paediatric patients with/without neutropenia, environmental samples, and normal adult population oral samples. Although a high proteinase activity was observed in all isolates, multi-drug resistance was observed amongst normal population isolates. Furthermore, neutropenic patient isolates were genetically divergent from other populations. Detected genotypes were mainly related to previously reported Iranian, Spanish, and Chinese genotypes. Candida glabrata has a critical distinction due to its haploid genome. Improving our knowledge about the antifungal susceptibility profile associated with this species is essential, especially in neutropenic patients.

Abstract

This study aimed to detect different genotypes of Candida glabrata isolates in paediatric patients with and without neutropenia utilizing microsatellite length polymorphism (MLP) and its correlation with drug resistance and enzymatic activity were assessed. Samples from neutropenic and non-neutropenic patients were collected from November 2020 to November 2021. Thirty-six C. glabrata strains were isolated and identified using classical and molecular methods. Then, C. glabrata isolates were genotyped by the MLP technique, and their antifungal susceptibility was performed based on the CLSI M27 guideline. Eighteen different multi-loci genotypes (G1–G18) were detected based on MLP analysis. Analysis of molecular variance revealed high genetic variation within populations (94%) and low genetic differentiation amongst populations (6%). Also, 40% (n = 4) of isolates from neutropenic patients were non-wild-type for posaconazole, and 30% (n = 3) were resistant to caspofungin. Very strong hemolytic and proteinase activity were seen in 97·2 and 86·1% of isolates. Candida glabrata strains from neutropenic patients were genetically divergent from other populations. The minimum spanning tree shows that observed genotypes were mainly related to previously reported genotypes from Iran, Spain, and China.