Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida parapsilosis Species Complex Blood Isolates
Clonal expansion of fluconazole resistant (FLZ-R) Candida parapsilosis isolates is increasingly being identified in many countries, while there is no study exploring the antifungal susceptibility pattern, genetic diversity, and clinical information for Iranian C. parapsilosis blood isolates. Candida...
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Veröffentlicht in: | Frontiers in cellular and infection microbiology 2020-05, Vol.10, p.206-206 |
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Sprache: | eng |
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Zusammenfassung: | Clonal expansion of fluconazole resistant (FLZ-R)
Candida parapsilosis
isolates is increasingly being identified in many countries, while there is no study exploring the antifungal susceptibility pattern, genetic diversity, and clinical information for Iranian
C. parapsilosis
blood isolates.
Candida parapsilosis
species complex blood isolates (
n
= 98) were recovered from nine hospitals located in three major cities, identified by MALDI-TOF MS, and their genetic relatedness was examined by AFLP fingerprinting. Antifungal susceptibility testing followed CLSI-M27-A3 and
ERG11, MRR1
and hotspots 1/2 (HS1/2) of
FKS1
were sequenced to assess the azole and echinocandin resistance mechanisms, respectively. Ninety-four
C. parapsilosis
and four
Candida orthopsilosis
isolates were identified from 90 patients. Only 43 patients received systemic antifungal drugs with fluconazole as the main antifungal used. The overall mortality rate was 46.6% (42/90) and death mostly occurred for those receiving systemic antifungals (25/43) relative to those not treated (17/47). Although, antifungal-resistance was rare, one isolate was multidrug-resistant (FLZ = 16 μg/ml and micafungin = 8 μg/ml) and the infected patient showed therapeutic failure to FLZ prophylaxis. Mutations causing azole and echinocandin resistance were not found in the genes studied. AFLP revealed five genotypes (G) and G1 was the main one (59/94; 62.7%). Clinical outcome was significantly associated with city (
P
= 0.02, α |
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ISSN: | 2235-2988 2235-2988 |
DOI: | 10.3389/fcimb.2020.00206 |