Candida krusei (Pichia kudriavzevii) multilocus sequence typing and antifungal susceptibility profile in Cameroon.

Abstract

Among the Candida species commonly involved in superficial and more significant life-threatening infections, C. krusei exhibits the most worrisome resistance profile to antifungals. This study aimed to analyse the population structure using multilocus sequence typing (MLST), and to evaluate the antifungal susceptibility profile of C. krusei isolated from patients living with human immunodeficiency virus (HIV) in Cameroon. C. krusei isolated from stool, urine, mouth and vaginal samples were identified using routine laboratory techniques and matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF MS). The C. krusei isolates were further analysed by MLST. In vitro antifungal susceptibility testing was performed using the Sensititre Yeast One™ microdilution technique. Forty three (43) C. krusei isolates were included in the study. The MLST identified 32 Diploid sequence type (DST), of which 31 were new that were not included in the current database. New alleles were not observed. Different DSTs were observed in isolates from the same geographical area, from different anatomical sites in the same patient. An eBURST analysis clustered all identified DSTs of former isolates in clonal complex 1. Heterogeneous antifungal MICs were observed in isolates of the same DST and/or from the same geographical area. 32.6% of the isolates displayed a resistant or non-wild-type phenotype to at least 3 distinct antifungal agent classes. The achieved results support the setting up of molecular epidemiology and antifungal resistance surveillance of C. krusei.