Over expression of efflux pumps genes in resistant Candida albicans clinical isolated from oral colonization in Iranian HIV-positive patients

Oral candidiasis is mainly treated with the use of Fluconazole. Treatment of oral candidiasis may be problematic due to either inherent resistance of candida species or acquired drug-resistance. Antifungal drugs including Azole could cause drug-resistance in C. albicans in two main mechanisms, these mechanisms include over expression of multi-drug resistance transport proteins such as MDR1 (a major facilitator) or CDR1 which is an ABC transporter. Fluconazole MIC in 66 clinical isolates of C. albicans were calculated by broth microdilution method and interpreted following CLSI-M27-A3 guidelines. Then, 15 clinically resistant strains of C. albicans were used for total RNA extraction using hot phenol method. cDNA was created using the MULV Reverse Transcriptase and random hexamer primers stock. Expression levels of MDR1 and CDR1 genes in 15 resistance clinical isolates of C. albicans were measured by semi quantitative RT-PCR (qRT-PCR). Actin gene ACT1was used as control. We observed increased mRNA levels of CDR1, MDR1 in 2 and 8 fluconazole-resistant isolates. The results showed that using q-RT-PCR, to determine the expression of resistance genes MDR1 and CDR1, is appropriate.