Molecular Detection, Sequencing, and Expression Analysis of ALS Genes in Clinical Candida spp. Isolates with Antifungal Resistance

The agglutinin-like sequence (ALS) family is crucial for Candida spp., particularly C. albicans, as it aids in adhesion to biotic and abiotic membranes and formation of virulence factors.This study was conducted to identify and measure the expression levels of ALS genes in Candida species isolates from clinical specimens.A total of 276 clinical samples (vaginal, oral, and blood) were obtained.The isolates were characterized, genetic material extracted, ALS genes detected, nucleotide sequence determined, and gene expression measured after antifungal treatment of oral and vaginal isolates.The study found a significant difference (p 0.05) among the number of isolates; 135 (48.91%)Candida positive isolates, with C. albicans being the most common species.Also, 15% of isolates were resistant to nystatin.Most Candida species had ALS genes, except for C. kefyr and C. lusitaniae, which were not detected.The gene expression analysis before and after treatment with fluconazole and nystatin revealed that C. albicans isolates from the mouth had higher gene expression than vaginal isolates, with gene expression reaching 92.82 and 17.52, respectively, for the two antifungal agents, making them resistant to antifungals.The ALS1 gene expression was highly elevated in antifungalresistant isolates, while it was reduced in susceptible isolates.The study's findings highlight the prevalence of ALS genes in Candida species and could be used as a marker of drug resistance.