First Report of Fluconazole-Resistant Candida parapsilosis Harbouring the G458S ERG11p Substitution in a Brazilian Hospital.

IF 3.4 2区医学 Q1 DERMATOLOGY

Mycoses Pub Date : 2026-03-01 DOI:10.1111/myc.70160

Sarah Santos Gonçalves, Simone Bravim Maifrede, Eduardo Yäkel, Pedro Massaroni Peçanha, Francisco Ozório Bessa-Neto, Rodrigo Cayô, Anderson Messias Rodrigues, Patricia Muñoz, Pilar Escribano, Jesús Guinea

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Abstract

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

Objectives: To investigate fluconazole resistance among Candida parapsilosis complex isolates from patients admitted to three Brazilian hospitals, and to characterise resistance mechanisms and clonal relatedness.

Patients/methods: A total of 76 C. parapsilosis complex isolates were collected from 60 patients hospitalised at three medical centres (H1-H3) located in Vitória, Espírito Santo state (2017-2023). Of these, 38 isolates were obtained from bloodstream cultures, four from catheter tips and 34 from an ICU surveillance study conducted at H1. In vitro susceptibility testing was performed according to the E.Def 7.4 EUCAST method. C. parapsilosis sensu stricto isolates were genotyped using microsatellite markers, and the ERG11 gene was sequenced in resistant isolates.

Results: Candida parapsilosis sensu stricto was the most common species (65/76 isolates; 85.5%), followed by C. orthopsilosis (n = 8, 10.5%), and C. metapsilosis (n = 3, 4%). Among the C. parapsilosis sensu stricto isolates, 5/65 (7.7%) were fluconazole-resistant, harboured the G458S ERG11p substitution, and were detected in 2019 and 2020. Only one fluconazole-resistant isolate was also voriconazole-resistant; all isolates were susceptible to the remaining agents. Fluconazole-resistant isolates sourced from H2 were grouped into two unrelated genotypes, and recovered from patients with haematological malignancies, tumours and central nervous system disorders. Only two patients had a history of azole exposure.

Conclusions: This is the first report of fluconazole-resistant C. parapsilosis sensu stricto isolates harbouring the G458S ERG11p substitution in Brazil. Here reported isolates showed resistance to fluconazole alone, which is an unusual pattern among C. parapsilosis sensu stricto isolates harbouring the G458S substitution.

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巴西一家医院中含有G458S ERG11p替代的氟康唑耐药假丝酵母菌伴假丝酵母菌病首例报告

背景：氟康唑耐药假丝酵母菌病是一个值得关注的问题。目的：调查从巴西三家医院收治的患者中分离出的假丝酵母菌复合体对氟康唑的耐药性，并确定耐药机制和克隆相关性。患者/方法：2017-2023年，从位于Vitória、Espírito Santo州的3个医疗中心（H1-H3）的60名住院患者中共收集了76株复瓣弓形虫分离株。其中，38个分离株来自血流培养，4个来自导管尖端，34个来自H1进行的ICU监测研究。体外药敏试验采用E.Def 7.4 EUCAST法。采用微卫星标记技术对严格疏裂菌进行基因分型，并对耐药菌株进行ERG11基因测序。结果：最常见的菌种为严格样假丝酵母（65/76株，占85.5%），其次为直硅假丝酵母（8株，占10.5%）和变硅假丝酵母（3株，占4%）。其中，5/65（7.7%）对氟康唑耐药，含有G458S ERG11p取代，于2019年和2020年检出。只有一株氟康唑耐药菌株同时对伏立康唑耐药；所有分离株均对其余病原敏感。来自H2的氟康唑耐药分离株被分为两个不相关的基因型，分别从血液恶性肿瘤、肿瘤和中枢神经系统疾病患者中恢复。仅有2例患者有唑暴露史。结论：这是巴西首次报道含有G458S ERG11p替代基因的耐氟康唑严格疏裂菌分离株。这里报道的分离株仅对氟康唑耐药，这在具有G458S取代的严格意义上的C. parapsilosis senu strict分离株中是不寻常的模式。

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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.