Molecular detection of agglutinin-like sequence 1 gene in Candida albicans that is isolated from diabetic foot patients

Objectives: Candida albicans is a microbe living within the natural human flora and is found in the upper respiratory tract, mouth, intestines, and vagina. C. albicans is able to cause infections that range from superficial infections of the skin to life-threatening systemic infections. Aim of Study: Detection of virulence gene agglutinin-like sequence (ALS) 1 by using molecular technology from clinical samples (C. albicans) that is isolated from ulcers of diabetic foot patients. Materials and Methods: This work was done on 235 patients who had diabetic foot patients admitted to the Specialized Center for Endocrinology and Diabetes (Baghdad Health Department/Rusafa) for the treatment of diabetic foot ulcers during November 2020 till March 2021. The collected samples of diabetic foot ulcers were cultured on different media (Sabouraud's dextrose agar with chloramphenicol for selective isolation and culturing of yeasts and HiCrome Candida Medium) for isolation of C. albicans fungus as well as automated biochemical test VITEK 2 system. The ALS1 virulence gene was detected by polymerase chain reaction using newly designed primers with a molecular size (419 bp). Results: Out of 235 Diabetic Foot Ulcer (DFU) cases, C. albicans were isolated in 20 (8.5%) patients (12 males and 8 females) of diabetic foot ulcers. In this study, the incidence of C. albicans infection at age [50–59 years] group was [40%], and increased at age group [60–69 years] to [55%], which represents the highest incidence of infection, then decreased in the age group [79–79 years] to [5%]). Seventy-five percent of the isolates were ALS1 gene positive. Conclusions: Diabetic people are more susceptible to infections due to their hyperglycemic environment and reduced immunity. The use of HiCrome Candida Identification Media with VITEK 2 system can help reduce the unnecessary steps of microorganism identification process. C. albicans infection is more common in males the females regarding diabetic foot ulceration. Majority of diabetic foot ulcers occur in older adults. ALS gene might be associated with diabetic foot ulceration.