Abstract：
Candida species are amongst the commensals of the mucosal surfaces of the human body which include the oral cavity, vagina, and intestinal mucosa. Fungal infections are on the rise worldwide. The overall burden of infections due to fungi is difficult to estimate because the majority of them remain undiagnosed. The present study aims to determine the burden of antifungal resistance in low socioeconomic country, Pakistan and the frequency of ERG11 and MDR1 genes involved. A total of 636 Candida isolates were obtained from various tertiary care institutions in Lahore in the form of culture on various culture plates. Sabouraud agar culture plates were used to culture the Candida spp. Antifungal resistance was determined against Fluconazole, Itraconazole, Ketoconazole, and Nystatin via disk diffusion technique. Most resistance was observed against Fluconazole followed by Itraconazole, Ketoconazole, and Nystatin. The Candida isolates recovering from CVP tip and tissue have a high resistance profile. Candida species resistant to at least two antifungals were chosen for further ERG11 and MDR1 detection through real-time PCR. Among 255 Candida isolates, 240 contained ERG11 gene while MDR1 gene is present in 149 Candida isolates. The isolates carrying both genes were tested by the broth microdilution technique for the susceptibility against cycloheximide, all of them were able to grow in cycloheximide. The genetic determinants of antifungal resistance such as ERG11 and MDR1 are as important in the multidrug resistance against a variety of compounds and antifungal drugs.
摘要：
念珠菌属是人体粘膜表面的共生体，包括口腔，阴道,和肠粘膜。真菌感染在世界范围内呈上升趋势。由于真菌引起的感染的总体负担很难估计，因为它们中的大多数仍未被诊断。本研究旨在确定低社会经济国家的抗真菌耐药性负担，巴基斯坦与ERG11和MDR1基因的频率有关。从拉合尔的各种三级护理机构以在各种培养板上培养的形式获得了总共636种念珠菌分离物。使用Sabouraud琼脂培养板培养念珠菌。确定了对氟康唑的抗真菌耐药性，伊曲康唑,酮康唑,和制霉菌素通过圆盘扩散技术。对氟康唑的耐药性最多，其次是伊曲康唑，酮康唑,还有制霉菌素.从CVP尖端和组织恢复的念珠菌分离物具有高抗性特征。选择对至少两种抗真菌剂具有抗性的念珠菌物种用于通过实时PCR进一步检测ERG11和MDR1。在255株念珠菌中，240株含有ERG11基因，而149株念珠菌中存在MDR1基因。通过肉汤微量稀释技术测试了携带这两个基因的分离株对环己酰亚胺的敏感性，它们都能在环己酰亚胺中生长。诸如ERG11和MDR1的抗真菌耐药性的遗传决定因子在针对多种化合物和抗真菌药物的多药耐药性中同样重要。
