Molecular identification, virulence gene profiling, and antifungal susceptibility of Candida albicans isolates from women with urinary tract infections

Muna F.  Jihad; Manal B.  Salih

doi:10.31450/ukrjnd.1(85).2025.05

Muna F. Jihad Department of Biology, College of Science, University of Thi-Qar, Thi-Qar, Iraq https://orcid.org/0009-0000-5552-2867
Manal B. Salih Department of Biology, College of Science, University of Thi-Qar, Thi-Qar, Iraq https://orcid.org/0009-0004-1583-0274

DOI: https://doi.org/10.31450/ukrjnd.1(85).2025.05

Keywords: Candida albicans, urinary tract infection, antifungal resistance, virulence genes, identification.

Abstract

Candida species are increasingly recognized as causative agents of urinary tract infections (UTIs), particularly in immunocompromised individuals. Among them, Candida albicans is the most prevalent and exhibits virulence factors that enhance adhesion, biofilm formation, and antifungal resistance. This study investigates the molecular identification, antifungal resistance profiles, and virulence gene prevalence (ALS1, ALS3, HWP1) in C. albicans isolates from women with UTIs in Thi-Qar Province, Iraq.

Methods. A total of 150 urine samples were collected from women with UTIs and control groups. Candida species were isolated on Sabouraud Dextrose Agar and identified using phenotypic (Gram staining, germ tube test, CHROM agar) and molecular methods (PCR using ITS1 and ITS4 primers). Antifungal susceptibility testing was performed against seven antifungal agents using the disc diffusion method. Virulence genes (ALS1, ALS3, HWP1) were detected via PCR, and sequencing was conducted for ALS1 and ALS3 genes to assess genetic variation.

Results. C. albicans was the most frequently isolated species (54%), followed by C. krusei (24%), C. glabrata (16%), and C. tropicalis (6%). Antifungal resistance was highest against itraconazole (96.3%), fluconazole (88.9%), and voriconazole (85.2%), whereas amphotericin B (29.6%) and nystatin (18.5%) exhibited the lowest resistance rates. PCR analysis revealed high prevalence rates for virulence genes: HWP1 (96.3%), ALS1 (88.8%), and ALS3 (77.7%). DNA sequencing confirmed the presence of genetic diversity among isolates.

Conclusion. The study highlights the significant role of C. albicans in UTIs and its increasing resistance to azole antifungals. The high prevalence of virulence genes suggests a strong pathogenic potential, emphasizing the need for effective antifungal stewardship and molecular surveillance to manage Candida infections in clinical settings.

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