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Published on: December 28, 2017
Investigation of clonal relationship in hospital-associated Candida parapsilosis isolates
Mahmut Cem Ergon1, Ebru Demiray Gürbüz2, Nazlı Arslan2
1Faculty of Medicine, Department of Medical Microbiology, Dokuz Eylül University, İnciraltı, İzmir, 35340, Turkey. cem.ergon@deu.edu.tr.
Purpose:
We aimed to investigate the clonal relationship and antifungal susceptibility of C. parapsilosis isolated from hospitalized patients and to determine whether it is due to transmission or not and the spread status of resistant isolates.
Methods:
Between January 2017 and June 2019, totally 277 C parapsilosis isolated from blood, urine and catheter samples of adult or pediatric in-patient (intensive care and service) who applied to Mycology laboratory in our hospital were included in the study. All isolates were identified using conventional methods, API 20 C AUX (Biomerieux, France) semi-automated system and confirmed by MALDI-TOF MS Biotyper Smart (Bruker Daltonik GmbH, Germany). Randomly amplified polymorphic DNA (RAPD) PCR method was used for molecular genotyping of isolates. MIC values for fluconazole, anidulafungin and amphotericin B were determined according to the M27-A3 CLSI broth microdilution reference method guideline.
Results:
Seven different band patterns (A-G) were detected in 277 isolates by RAPD PCR method. According to the rank order of the isolates, 170 (61.37%) C, 65 (23.47%) A, 18 (6.50%) G, 11 (3.97%) B, six (2.17%) E, two (0.72%) F and one (0.36%) D patterns were determined. When the band patterns of the isolates were evaluated according to the years, it was detected that C pattern continued between 2017 and 2019 and that all isolates continued to spread only as C pattern in 2019. While 211 (76.17%) of the isolates were resistant to fluconazole (≥ 8 µg/ml), two (0.72%) were resistant to amphotericin B (≥ 2 µg/ml) and two (0.72%) were intermediate to anidulafungin.
Conclusions:
It is noteworthy that the spread of the C pattern in C. parapsilosis strains has increased over the years and is the main pattern isolated from the whole hospital. The detection of high fluconazole resistance in C. parapsilosis isolates in our hospital may also be related to the dominant pattern.
Insights
A dominant C. parapsilosis strain (pattern C) spread throughout the hospital, showing increased prevalence over time. This pattern is linked to high fluconazole resistance, suggesting potential transmission of resistant Candida parapsilosis isolates.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Molecular Epidemiology
Background:
- Candida parapsilosis is a significant cause of hospital-acquired infections.
- Understanding the clonal diversity and antifungal resistance patterns is crucial for infection control.
Purpose of the Study:
- To investigate the clonal relationships of Candida parapsilosis isolates from hospitalized patients.
- To determine the antifungal susceptibility and transmission dynamics of C. parapsilosis.
Main Methods:
- Molecular genotyping using Randomly Amplified Polymorphic DNA (RAPD) PCR.
- Antifungal susceptibility testing for fluconazole, anidulafungin, and amphotericin B.
- Identification confirmed by MALDI-TOF MS.
Main Results:
- Seven distinct RAPD patterns (A-G) were identified among 277 C. parapsilosis isolates.
- Pattern C was the most prevalent (61.37%) and showed increasing spread from 2017 to 2019.
- High fluconazole resistance (76.17%) was observed, potentially associated with the dominant pattern C.
Conclusions:
- The increasing prevalence of C. parapsilosis pattern C suggests clonal spread within the hospital.
- High fluconazole resistance among C. parapsilosis isolates may be linked to the dominant circulating strain.
- These findings highlight the importance of molecular surveillance for controlling Candida infections.
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