Evaluation of virulence factors and azole resistance mechanisms of Candida tropicalis isolates from head and neck cancer patients with OPC

is one of the major non- species causing nosocomial infection. There is limited data about mechanisms of azole-resistance and virulence factors of . This study was designed to investigate molecular mechanism of azole-resistance and major virulence factors of isolated from oropharyngeal candidiasis in head and neck cancer patients. After collecting 38 clinical isolates, antifungal susceptibility pattern and the expression levels of and were evaluated. Moreover, proteinase and phospholipase activity and biofilm formation of the isolates were investigated as virulence factors. We detected fluconazole resistance in 7 isolates. The expression levels of and were increased respectively. Protease activity and biofilm formation were seen in all isolates. Five isolates did not exhibit phospholipase activity. Taken together, the overexpressions of and genes were found in fluconazole resistant , isolated from oropharyngeal candidiasis patients. Also, voriconazole was an effective antifungal against isolates. The observed high protease enzyme activity and biofilm formation suggested strong pathogenicity of these isolates.