Virulence Attributes of Candida albicans from Nail Infections: A Study of Antifungal Resistance and Exoenzyme Production.

Background and Objective: Candidiasis is the most common yeast-related infection worldwide, with infections caused by Candida albicans increasing over the past two decades. Limited information exists regarding its pathogenic characteristics. This study aimed to evaluate drug resistance, pathogenicity, and biological mechanisms of C. albicans to inform prevention and treatment strategies.
Materials and Methods: Antifungal susceptibility to fluconazole, voriconazole, amphotericin B, and caspofungin, phospholipase and proteinase activities, and biofilm formation were assessed in 26 C. albicans isolates obtained from patients’ nails. Identification was confirmed on CHROMagar medium.
Results: Phospholipase activity was high in 6 isolates, moderate in 14, and low in 6. Proteinase activity was high in 3 isolates, moderate in 5, and low in 18. All isolates formed biofilms. MIC testing revealed fluconazole susceptibility in 89.5% of isolates; amphotericin B, 100%; voriconazole, 90%; and caspofungin, 80%. Intermediate or dose-dependent responses were observed in the remaining isolates, with 10.5% resistance to caspofungin.
Conclusion: Candida albicans employs multiple pathogenic mechanisms, posing a persistent risk for infections. Antifungal susceptibility assessment is essential for selecting effective treatments and designing preventive measures.