Evaluation of virulence factors of clinical Candida isolates and the anti-biofilm activity of Elettaria cardamomum against MDR Candida albicans

Background and In current scenario, the life threatening fungal infection causing Candida species is a problematic to cure. The present study was an attempt to evaluate the virulence factors and antifungal susceptibility patterns of different Candida species isolated from hospitalized patients and it inhibited by extracts of Elettaria cardamomum.
A total of 202 isolates of different candida species were obtained from three government hospitals (Senthamangalam, Tiruchengode, Namakkal) in Namakkal district. The collected isolates were identified by using standard biochemical tests. Germ tube method used to differentiate the Candida albicans from other species of Candida. Candida species were tested for virulence factors such as biofilm, protease, phospholipase activity. The MIC effect of Elettaria cardamomum on MDR biofilm formation was determined by plate and tube methods.
The identified 202 isolates of Candida species were Candida albicans (74/202), Candida glabrata (53/202), Candida parapsilosis (44/202) Candida tropicalis (15/202) and Candida dubliniensis (16/202). Then they were subjected to antifungal susceptibility testing and virulence factors determination. In biofilm production, non Candida albicans species such as Candida dubliniensis showed 75%. In protease activity, among the Candida species, Candida parapsilosis (75%) showed the highest percentage of protease production. In phospholipase activity, Candida species were shown 62.87% of strong positive. In MIC method, acetone extract completely inhibited the biofilm at the concentration of 125 µl; it has the concentration of 56.25 µg concentration of E.cardamomum. When compared to ethanol, acetone had high activity against the biofilm.
The pathogenic Candida albicans was inhibited by the ethanol and acetone extract of Elettaria cardamomum. In recent years MDR and Biofilm forming pathogenic Candida spp. were increased in the clinical field so the herbal derivative medicine may cure the infection without side effect and prevent the mortality.