Whole genome analysis of azole-resistant Candida tropicalis candidemia outbreak in a haematology ward: A single centre experience.

IF 3.5 3区医学 Q3 INFECTIOUS DISEASES

Medical mycology Pub Date : 2026-02-28 DOI:10.1093/mmy/myag020

Xue Ting Tan, Abdul Hadi Siti Rohani, Hong Keng Liew, Lee Lee Low

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Abstract

The emergence of azole-resistant Candida tropicalis poses a significant threat in healthcare settings. It contributed to high morbidity and mortality, particularly in those undergoing chemotherapy for haematological diseases. In this study, we investigated a suspected outbreak in the haematology ward of Hospital Sultanah Bahiyah involving three patients, using whole genome sequencing. Azole-resistant C. tropicalis was isolated from all patients during episodes of neutropenic sepsis following chemotherapy. The index patient developed breakthrough candidemia while receiving fluconazole prophylaxis. Subsequently, the second and third patients developed candidemia occurring four days apart. Consequently, phylogenetic analysis confirmed that these isolates formed a clade closely related to other C. tropicalis strains, indicating a clonal nosocomial transmission. Further analysis demonstrated that, among key azole resistance genes, mutations were specifically identified in ERG11. Our findings underscore the critical role of genomic surveillance in uncovering transmission chains of multidrug-resistant fungal pathogens and highlight an urgent need for reinforced infection control measures to contain the spread of this clone.

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血液科病房耐唑热带念珠菌爆发的全基因组分析：单一中心经验。

耐唑热带假丝酵母的出现对卫生保健机构构成了重大威胁。它造成了高发病率和高死亡率，特别是在那些因血液病而接受化疗的患者中。在这项研究中，我们使用全基因组测序（WGS）调查了苏丹巴希耶医院血液科病房发生的一起疑似疫情，涉及3名患者。在化疗后中性粒细胞减少性败血症发作期间，从所有患者中分离出抗唑热带念珠菌。指数患者在接受氟康唑预防治疗时出现突破性念珠菌血症。随后，第二例和第三例患者发生念珠菌血症，时间间隔4天。因此，系统发育分析证实，这些分离株形成了一个与其他热带假体菌株密切相关的分支，表明克隆性医院传播。进一步分析表明，在关键的抗唑基因中，ERG11特异突变。我们的研究结果强调了基因组监测在发现多药耐药真菌病原体传播链中的关键作用，并强调了加强感染控制措施以遏制该克隆的传播的迫切需要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medical mycology 医学-兽医学

CiteScore

5.70

自引率

3.40%

发文量

632

审稿时长

12 months

期刊介绍： Medical Mycology is a peer-reviewed international journal that focuses on original and innovative basic and applied studies, as well as learned reviews on all aspects of medical, veterinary and environmental mycology as related to disease. The objective is to present the highest quality scientific reports from throughout the world on divergent topics. These topics include the phylogeny of fungal pathogens, epidemiology and public health mycology themes, new approaches in the diagnosis and treatment of mycoses including clinical trials and guidelines, pharmacology and antifungal susceptibilities, changes in taxonomy, description of new or unusual fungi associated with human or animal disease, immunology of fungal infections, vaccinology for prevention of fungal infections, pathogenesis and virulence, and the molecular biology of pathogenic fungi in vitro and in vivo, including genomics, transcriptomics, metabolomics, and proteomics. Case reports are no longer accepted. In addition, studies of natural products showing inhibitory activity against pathogenic fungi are not accepted without chemical characterization and identification of the compounds responsible for the inhibitory activity.