Fluconazole-resistant Candida parapsilosis genotypes from hospitals located in five Spanish cities and one in Italy: Description of azole-resistance profiles associated with the Y132F ERG11p substitution.

IF 4.1 2区医学 Q1 DERMATOLOGY

Mycoses Pub Date : 2024-03-01 DOI:10.1111/myc.13706

Aina Mesquida, Eva Alcoceba, Eduardo Padilla, Aída Ramírez, Paloma Merino, Fernando González-Romo, Elena De Carolis, Maurizio Sanguinetti, María de Los Ángeles Mantecón-Vallejo, María Muñoz-Algarra, Teresa Durán-Valle, Ana Pérez-Ayala, Elia Gómez-García-de-la-Pedrosa, María Del Carmen Martínez-Jiménez, Miguel Ángel Sánchez-Castellano, Inmaculada Quiles-Melero, María Soledad Cuétara, Aída Sánchez-García, Patricia Muñoz, Pilar Escribano, Jesús Guinea

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引用次数: 0

Abstract

Background: Fluconazole-resistant Candida parapsilosis is a matter of concern.

Objectives: To describe fluconazole-resistant C. parapsilosis genotypes circulating across hospitals in Spain and Rome and to study their azole-resistance profile associated with ERG11p substitutions.

Patients/methods: We selected fluconazole-resistant C. parapsilosis isolates (n = 528 from 2019 to 2023; MIC ≥8 mg/L according to EUCAST) from patients admitted to 13 hospitals located in five Spanish cities and Rome. Additionally, we tested voriconazole, posaconazole, isavuconazole, amphotericin B, micafungin, anidulafungin and ibrexafungerp susceptibility.

Results: Of the 53 genotypes found, 49 harboured the Y132F substitution, five of which were dominating city-specific genotypes involving almost half the isolates. Another genotype involved isolates harbouring the G458S substitution. Finally, we found two genotypes with the wild-type ERG11 gene sequence and one with the R398I substitution. All isolates were fully susceptible/wild-type to amphotericin B, anidulafungin, micafungin and ibrexafungerp. The azole-resistance patterns found were: voriconazole-resistant (74.1%) or voriconazole-intermediate (25.2%), posaconazole-resistant (10%) and isavuconazole non-wild-type (47.5%). Fluconazole-resistant and voriconazole non-wild-type isolates were likely to harbour substitution Y132F if posaconazole was wild type; however, if posaconazole was non-wild type, substitution G458S was indicated if isavuconazole MIC was >0.125 mg/L or substitution Y132F if isavuconazole MIC was ≤0.125 mg/L.

Conclusions: We detected a recent clonal spread of fluconazole-resistant C. parapsilosis across some cities in Spain, mostly driven by dominating city-specific genotypes, which involved a large number of isolates harbouring the Y132F ERG11p substitution. Isolates harbouring substitution Y132F can be suspected because they are non-susceptible to voriconazole and rarely posaconazole-resistant.

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西班牙五个城市和意大利一个城市的医院中对氟康唑耐药的副丝状念珠菌基因型：描述与 Y132F ERG11p 替代相关的唑类耐药性特征。

背景耐氟康唑的副丝状念珠菌是一个令人担忧的问题：描述西班牙和罗马各医院中流行的耐氟康唑副银屑病基因型，并研究其与ERG11p置换相关的唑类耐药性特征：我们从西班牙5个城市和罗马的13家医院收治的患者中选取了对氟康唑耐药的副丝虫分离株（2019年至2023年，n = 528；根据EUCAST，MIC ≥8 mg/L）。此外，我们还检测了伏立康唑、泊沙康唑、异武康唑、两性霉素 B、米卡芬净、阿尼妥芬净和伊布沙芬净的药敏性：在发现的 53 个基因型中，49 个带有 Y132F 取代，其中 5 个是城市特有的主要基因型，几乎涉及一半的分离株。另一种基因型涉及携带 G458S 取代的分离株。最后，我们发现了两个带有野生型 ERG11 基因序列的基因型和一个带有 R398I 取代序列的基因型。所有分离株都对两性霉素 B、阿尼妥芬菌素、米考芬菌素和伊布沙芬菌酯完全敏感/野生型。发现的唑类抗药性模式有：伏立康唑抗药性（74.1%）或伏立康唑中间型（25.2%）、泊沙康唑抗药性（10%）和异武康唑非野生型（47.5%）。如果泊沙康唑为野生型，则氟康唑耐药和伏立康唑非野生型分离株可能含有Y132F替代物；但是，如果泊沙康唑为非野生型，则如果异黄康唑MIC>0.125 mg/L，则表明含有G458S替代物；如果异黄康唑MIC≤0.125 mg/L，则表明含有Y132F替代物：我们在西班牙的一些城市发现了对氟康唑耐药的副猪嗜血杆菌近期的克隆传播，主要是由城市特异性基因型驱动的，其中涉及大量携带Y132F ERG11p替代基因的分离株。携带 Y132F 替换的分离株可能是可疑的，因为它们对伏立康唑不敏感，也很少对泊沙康唑产生抗药性。

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来源期刊

Mycoses 医学-皮肤病学

CiteScore

10.00

自引率

8.20%

发文量

143

审稿时长

6-12 weeks

期刊介绍： The journal Mycoses provides an international forum for original papers in English on the pathogenesis, diagnosis, therapy, prophylaxis, and epidemiology of fungal infectious diseases in humans as well as on the biology of pathogenic fungi. Medical mycology as part of medical microbiology is advancing rapidly. Effective therapeutic strategies are already available in chemotherapy and are being further developed. Their application requires reliable laboratory diagnostic techniques, which, in turn, result from mycological basic research. Opportunistic mycoses vary greatly in their clinical and pathological symptoms, because the underlying disease of a patient at risk decisively determines their symptomatology and progress. The journal Mycoses is therefore of interest to scientists in fundamental mycological research, mycological laboratory diagnosticians and clinicians interested in fungal infections.