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Updated: Jul 15, 2026

Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
Published on: December 28, 2017
The first reported case of candidemia caused by the novel Candida tropicalis diploid sequence type 1515
Chuan H Ding1, Shiamala D Navarathinam1, Hui-Min Neoh2
1Department of Medical Microbiology and Immunology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Introduction:
Since the dawn of the new millennium, Candida species have been increasingly implicated as a cause of both healthcare-associated as well as opportunistic yeast infections, due to the widespread use of indwelling medical devices, total parenteral nutrition, systemic corticosteroids, cytotoxic chemotherapy, and broad-spectrum antibiotics. Candida tropicalis is a pathogenic Candida species associated with considerable morbidity, mortality, and drug resistance issues on a global scale.
Methodology:
We report a case of a 43-year-old man who was admitted to our hospital for further management of severe coronavirus disease 2019 (COVID-19) pneumonia. During his stay in the ward, he received systemic corticosteroids for a total duration of 32 days. A broad-spectrum antibiotic (piperacillin-tazobactam) was also given due to copious amounts of tracheostomy secretions.
Results:
The patient's fever recurred following an afebrile interval of 11 days, and C. tropicalis was cultured from his blood. The yeast was highly resistant to fluconazole and voriconazole but remained susceptible to echinocandins. Unfortunately, the patient was unable to receive any echinocandin and eventually succumbed to candidemia.
Conclusions:
Multilocus sequence typing was used to characterize C. tropicalis as a novel diploid sequence type (i.e., 1515) that has not been previously reported.
Insights
A case of Candida tropicalis bloodstream infection occurred in a patient with severe COVID-19 pneumonia. This yeast strain showed resistance to common antifungals, highlighting the need for new treatment strategies.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Critical Care Medicine
Background:
- Candida species are increasingly recognized as opportunistic pathogens, particularly in healthcare settings.
- Risk factors include indwelling devices, immunosuppression (corticosteroids, chemotherapy), and broad-spectrum antibiotics.
- Candida tropicalis is a significant pathogen associated with high morbidity, mortality, and drug resistance.
Purpose of the Study:
- To report a case of candidemia caused by Candida tropicalis in a patient with severe COVID-19 pneumonia.
- To highlight the antifungal resistance profile of the isolated Candida tropicalis strain.
- To characterize the genetic type of the Candida tropicalis isolate.
Main Methods:
- A case report of a 43-year-old male patient with severe COVID-19 pneumonia.
- Treatment included systemic corticosteroids and broad-spectrum antibiotics.
- Blood cultures identified Candida tropicalis; antifungal susceptibility testing was performed.
Main Results:
- The patient developed recurrent fever and Candida tropicalis bloodstream infection (candidemia).
- The isolate exhibited high resistance to fluconazole and voriconazole but remained susceptible to echinocandins.
- Despite susceptibility to echinocandins, the patient could not receive this treatment and unfortunately died.
Conclusions:
- Candida tropicalis can cause severe, drug-resistant infections in immunocompromised patients, including those with COVID-19.
- The isolated strain was identified as a novel diploid sequence type (ST 1515) via multilocus sequence typing.
- This case underscores the challenges in treating invasive candidiasis with limited therapeutic options.
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