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Updated: May 9, 2025
Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
Published on: December 28, 2017
Analysis of Antifungal Drug Resistance Among Candida Spp. and Other Pathogenic Yeasts Isolated from Patients in
Alina Olender1, Agnieszka Bogut1, Wojciech Dąbrowski2
1Chair and Department of Medical Microbiology, Medical University of Lublin, Lublin, Poland.
Objective:
The profile of Candida species and their sensitivity to antifungal drugs isolated from patients in Eastern Poland were analyzed. Identification and drug resistance interpretation issues for clinically significant rare species were investigated.
Methods:
A total of 197 yeast isolates were analyzed. Fungal identification was conducted using biochemical tests and MALDI-TOF. Minimum inhibitory concentrations (MICs) were determined for amphotericin B, fluconazole, itraconazole, voriconazole, isavuconazole, posaconazole, caspofungin, micafungin, and anidulafungin. Interpretation of results was based on the EUCAST, CLSI recommendations, and available literature.
Results:
The following species were identified: Candida albicans (n=78), C. glabrata (Nakaseomyces glabrata) (n=30), C. dubliniensis (n=23), C. krusei (Pichia kudriavzevii) (n=13), C. parapsilosis (n=13), C. tropicalis (n=7), C. kefyr (Kluyveromyces marxianus) (n=6), C. lusitaniae (Clavispora lusitaniae) (n=6), C. lipolytica (Yarrowia lipolytica) (n=3), C. famata (Debaryomyces hansenii) (n=2), C. intermedia (n=2), C. guillermondii (Meyerozyma guilliermondii) (n=2), C. ciferrii (n=1), C. orthopsilosis (n=1), C. pelliculosa (Wickerhamomyces anomalus) (n=1), C. shehatae (n=1), C. fabianii (Cyberlindnera fabianii) (n=1), Cryptococcus humicola (Vanrija humicola) (n=4), and Saccharomyces cerevisiae (n=3). The highest percentage of resistant strains was reported for C. albicans, C. glabrata, C. parapsilosis, C. tropicalis, and C. lusitaniae.
Conclusion:
Among the studied isolates, rare Candida species were identified. Their identification in routine diagnostics can be challenging, necessitating the use of MALDI-TOF MS. The wide spectrum of isolated species may complicate the establishment of a targeted antifungal therapy due to the lack of reference MIC ranges for the interpretation of antibiograms. Gradient strips are an accurate, reproducible, and convenient method for MIC determination.
Insights
This study analyzed 197 yeast isolates from Eastern Poland, identifying diverse Candida species and their antifungal drug sensitivity. Rare species pose identification challenges, complicating targeted antifungal therapy due to varied resistance patterns.
Area of Science:
- Medical Mycology
- Clinical Microbiology
- Antimicrobial Resistance
Background:
- The prevalence and antifungal susceptibility of *Candida* species are crucial for effective treatment of candidiasis.
- Identification of *Candida* species, especially rare ones, can be challenging in routine diagnostics.
- Understanding drug resistance profiles is essential for guiding antifungal therapy choices.
Purpose of the Study:
- To analyze the profile of *Candida* species and their antifungal drug sensitivity in patients from Eastern Poland.
- To investigate identification and drug resistance interpretation challenges for clinically significant rare *Candida* species.
Main Methods:
- Analysis of 197 yeast isolates using biochemical tests and MALDI-TOF MS for identification.
- Determination of Minimum Inhibitory Concentrations (MICs) for nine antifungal drugs against the isolates.
- Interpretation of antifungal susceptibility based on EUCAST, CLSI recommendations, and available literature.
Main Results:
- A wide spectrum of *Candida* species was identified, including common and rare species like *Candida albicans*, *C. glabrata*, and *C. lusitaniae*.
- The highest percentage of resistant strains was observed in *C. albicans*, *C. glabrata*, *C. parapsilosis*, *C. tropicalis*, and *C. lusitaniae*.
- Identification of rare *Candida* species presented diagnostic challenges.
Conclusions:
- MALDI-TOF MS is essential for the accurate identification of rare *Candida* species.
- The diverse species profile complicates targeted antifungal therapy due to a lack of established MIC breakpoints for rare species.
- Gradient strips offer an accurate, reproducible, and convenient method for MIC determination.
