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Evidence of Fluconazole-Resistant Candida parapsilosis Genotypes Spreading across Hospitals Located in Madrid, Spain and Harboring the Y132F ERG11p Substitution.

Judith Díaz-GarcíaAna GómezLuis AlcaláElena ReigadasCarlos Sánchez-CarrilloAna Pérez-AyalaElia Gómez-García de la PedrosaFernando González-RomoPaloma Merino-AmadorMaría Soledad CuétaraCoral García-EstebanInmaculada Quiles-MeleroNelly Daniela ZuritaMaría Muñoz-AlgarraIsabel Sánchez-RomeroMaría Teresa Durán-ValleAída Sánchez-GarcíaEva AlcocebaPatricia MuñozPilar EscribanoJesus Vicente Guineanull null
Published in: Antimicrobial agents and chemotherapy (2022)
We have been monitoring the antifungal resistance in Candida parapsilosis isolates collected from inpatients at Madrid metropolitan area hospitals for the last 3 years. The study aimed to elucidate the presence of fluconazole-resistant C. parapsilosis genotypes in Madrid. From January 2019 to December 2021, a total of 354 C. parapsilosis isolates ( n  = 346 patients) from blood (76.6%) or intraabdominal samples were collected and genotyped using species-specific microsatellite markers. Antifungal susceptibilities to amphotericin B, the triazoles, micafungin, anidulafungin, and ibrexafungerp were performed according to EUCAST E.Def 7.3.2; the ERG11 gene was sequenced in fluconazole-resistant isolates. A total of 13.6% ( n  = 48/354) isolates (one per patient) were found to be resistant to fluconazole and non-wild-type to voriconazole but fully susceptible to ibrexafungerp. Resistant isolates were mostly sourced from blood ( n  = 45/48, 93.8%) and were detected in five hospitals. Two hospitals accounted for a high proportion of resistant isolates ( n  = 41/48). Resistant isolates harbored either the Y132F ERG11p amino acid substitution ( n  = 43) or the G458S substitution ( n  = 5). Isolates harboring the Y132F substitution clustered into a clonal complex involving three genotypes (one genotype accounted for n  = 39/43 isolates) that were found in four hospitals. Isolates harboring the G458S substitution clustered into another genotype found in a fifth hospital. C. parapsilosis genotypes demonstrating resistance to fluconazole have been spreading across hospitals in Madrid, Spain. Over the last 3 years, the frequency of isolation of such isolates and the number of hospitals affected is on the rise.
Keyphrases
  • candida albicans
  • genetic diversity
  • healthcare
  • amino acid
  • ejection fraction
  • end stage renal disease
  • escherichia coli
  • dna methylation
  • peritoneal dialysis
  • wild type