Introduction: The aim of this study was to evaluate some virulence factors in Candida albicans isolates
from patients with onychomycosis and determine the correlation between these factors and the antifungal
resistance profle
Methods: Seventy species of C. albicans were confrmed using polymerase chain reaction amplifcation of
the HWP1 gene. According to the Clinical & Laboratory Standards Institute guidelines, the susceptibility
profle of four antifungal agents was investigated, and the production of aspartyl protease, phospholipase,
haemolysin, and bioflm was determined. The correlation between these profles was also investigated
Results: The isolates indicated different levels of resistance and production of virulence factors. Signifcant
correlations were observed between the minimum inhibitory concentration (MIC) of
fluconazole/itraconazole and bioflm production, between phospholipase production and fluconazole/
itraconazole MIC, and between fluconazole MIC and hemolytic activity in C. albicans isolates. The results
also showed significant correlations between phospholipase activity and bioflm production
Conclusions: Our fndings will contribute to a better understanding of the pathogenesis of C. albicans and
characterize the relationship between virulence factors and antifungal resistance, which may suggest new
therapeutic strategies considering the possible involvement of the virulence mechanism in the effectiveness
of treatment.
Keywords: Candida albicans. Virulence factors. Bioflm. Antifungal agents
