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Characterization of the Candida parapsilosis complex in East China: species distribution differs among cities

Yi P Ge1, Teun Boekhout, Ping Zhan

  • 1Department of Mycology, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, PR China.

Medical Mycology
|July 7, 2011
PubMed

Insights

The Candida parapsilosis complex in China is mainly composed of C. parapsilosis sensu stricto and C. metapsilosis. Most isolates showed susceptibility to common antifungal drugs, with some exceptions for itraconazole and micafungin.

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Molecular Biology

Background:

  • The Candida parapsilosis complex, a cause of hospital-acquired infections, was recently reclassified into three species: C. parapsilosis sensu stricto, C. orthopsilosis, and C. metapsilosis.
  • Limited data exists on the prevalence and characteristics of these species in China.

Purpose of the Study:

  • To investigate the species composition and antifungal susceptibility of Candida parapsilosis complex isolates from East China.
  • To identify genotypes within C. metapsilosis and establish a rapid identification method.

Main Methods:

  • Analysis of 57 Candida parapsilosis complex isolates from four Chinese cities using sequence analysis of the internal transcribed spacer region.
  • Development of a PCR-restriction fragment length polymorphism (PCR-RFLP) assay for species identification.

Main Results:

  • C. parapsilosis sensu stricto (71.9%) and C. metapsilosis (28.1%) were identified; C. orthopsilosis was not found.
  • A high prevalence of C. metapsilosis (60%) was noted in Nanchang.
  • Two genotypes were identified in C. metapsilosis strains.
  • Most isolates were susceptible to fluconazole, voriconazole, amphotericin B, and micafungin.
  • Dose-dependent susceptibility to itraconazole was observed in some C. parapsilosis sensu stricto and C. metapsilosis isolates.
  • C. parapsilosis sensu stricto showed lower susceptibility to micafungin compared to C. metapsilosis.

Conclusions:

  • C. parapsilosis sensu stricto and C. metapsilosis are the predominant species in East China.
  • The developed PCR-RFLP assay enables rapid identification of these species.
  • Antifungal susceptibility patterns highlight potential challenges with itraconazole and micafungin for specific species.

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