1887

Abstract

The group encompasses three species: , and . These species are phenotypically indistinguishable, and molecular methods are needed for their detection. We analysed 152 unique blood culture isolates of the group obtained during 1997–2011. The isolates were screened by PCR amplification of the gene encoding secondary alcohol dehydrogenase, followed by digestion with the restriction enzyme I. Isolates with RFLP patterns distinct from those of the group were characterized as (90.8 %), (8.6 %) and (0.6 %). Antifungal susceptibility tests indicated that all isolates were susceptible to itraconazole, amphotericin B and caspofungin. Although and isolates were susceptible to fluconazole, higher MICs (≥2 mg l) were observed for . Three isolates (2.0 %) of were resistant to voriconazole. Five C. isolates (3.3 %) were intermediate, and a single isolate (0.7 %) was resistant (MIC 16 mg l) to fluconazole. These data were confirmed using reference strains. It was observed that isolates were less susceptible to all triazoles, and this finding deserves further attention to assess the appearance of cross-resistance phenomena. In conclusion, and are involved in a small but significant number of invasive infections in Brazil.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.037812-0
2012-07-01
2024-04-28
Loading full text...

Full text loading...

/deliver/fulltext/jmm/61/7/1003.html?itemId=/content/journal/jmm/10.1099/jmm.0.037812-0&mimeType=html&fmt=ahah

References

  1. Almirante B., Rodríguez D., Cuenca-Estrella M., Almela M., Sanchez F., Ayats J., Alonso-Tarres C., Rodriguez-Tudela J. L., Pahissa A. Barcelona Candidemia Project Study Group 2006; Epidemiology, risk factors, and prognosis of Candida parapsilosis bloodstream infections: case–control population-based surveillance study of patients in Barcelona, Spain, from 2002 to 2003. J Clin Microbiol 44:1681–1685 [View Article][PubMed]
    [Google Scholar]
  2. Arendrup M. C. 2010; Epidemiology of invasive candidiasis. Curr Opin Crit Care 16:445–452 [View Article][PubMed]
    [Google Scholar]
  3. Asadzadeh M., Ahmad S., Al-Sweih N., Khan Z. U. 2009; Rapid molecular differentiation and genotypic heterogeneity among Candida parapsilosis and Candida orthopsilosis strains isolated from clinical specimens in Kuwait. J Med Microbiol 58:745–752 [View Article][PubMed]
    [Google Scholar]
  4. Chen Y.-C., Lin Y.-H., Chen K.-W., Lii J., Teng H.-J., Li S.-Y. 2010; Molecular epidemiology and antifungal susceptibility of Candida parapsilosis sensu stricto, Candida orthopsilosis, and Candida metapsilosis in Taiwan. Diagn Microbiol Infect Dis 68:284–292 [View Article][PubMed]
    [Google Scholar]
  5. Colombo A. L., Nucci M., Park B. J., Nouér S. A., Arthington-Skaggs B., da Matta D. A., Warnock D., Morgan J. for the Brazilian Network Candidemia Study 2006; Epidemiology of candidemia in Brazil: a nationwide sentinel surveillance of candidemia in eleven medical centers. J Clin Microbiol 44:2816–2823 [View Article][PubMed]
    [Google Scholar]
  6. Cuenca-Estrella M., Rodríguez-Tudela J. L., Córdoba S., Melhem M. C., Szeszs M. W., Castañeda E., Martínez G., Gabastou J. M. 2008; [Regional laboratory network for surveillance of invasive fungal infections and antifungal susceptibility in Latin America]. Rev Panam Salud Publica 23:129–134 (in Spanish) [View Article][PubMed]
    [Google Scholar]
  7. da Matta D. A., de Almeida L. P., Machado A. M., Azevedo A. C., Kusano E. J., Travassos N. F., Salomão R., Colombo A. L. 2007; Antifungal susceptibility of 1000 Candida bloodstream isolates to 5 antifungal drugs: results of a multicenter study conducted in São Paulo, Brazil, 1995–2003. Diagn Microbiol Infect Dis 57:399–404 [View Article][PubMed]
    [Google Scholar]
  8. de Toro M., Torres M. J., Maite R., Aznar J. 2011; Characterization of Candida parapsilosis complex isolates. Clin Microbiol Infect 17:418–424 [View Article][PubMed]
    [Google Scholar]
  9. Ghannoum M. A., Chen A., Buhari M., Chandra J., Mukherjee P. K., Baxa D., Golembieski A., Vazquez J. Á. 2009; Differential in vitro activity of anidulafungin, caspofungin and micafungin against Candida parapsilosis isolates recovered from a burn unit. Clin Microbiol Infect 15:274–279 [View Article][PubMed]
    [Google Scholar]
  10. Gleason T. G., May A. K., Caparelli D., Farr B. M., Sawyer R. G. 1997; Emerging evidence of selection of fluconazole-tolerant fungi in surgical intensive care units. Arch Surg 132:1197–1202 [View Article][PubMed]
    [Google Scholar]
  11. Gomez-Lopez A., Alastruey-Izquierdo A., Rodriguez D., Almirante B., Pahissa A., Rodriguez-Tudela J. L., Cuenca-Estrella M. Barcelona Candidemia Project Study Group 2008; Prevalence and susceptibility profile of Candida metapsilosis and Candida orthopsilosis: results from population-based surveillance of candidemia in Spain. Antimicrob Agents Chemother 52:1506–1509 [View Article]
    [Google Scholar]
  12. Gonçalves S. S., Amorim C. S., Nucci M., Padovan A. C., Briones M. R., Melo A. S., Colombo A. L. 2010; Prevalence rates and antifungal susceptibility profiles of the Candida parapsilosis species complex: results from a nationwide surveillance of candidaemia in Brazil. Clin Microbiol Infect 16:885–887[PubMed] [CrossRef]
    [Google Scholar]
  13. Gudlaugsson O., Gillespie S., Lee K., Vande Berg J., Hu J., Messer S., Herwaldt L., Pfaller M., Diekema D. 2003; Attributable mortality of nosocomial candidemia, revisited. Clin Infect Dis 37:1172–1177 [View Article][PubMed]
    [Google Scholar]
  14. Horn D. L., Neofytos D., Anaissie E. J., Fishman J. A., Steinbach W. J., Olyaei A. J., Marr K. A., Pfaller M. A., Chang C. H., Webster K. M. 2009; Epidemiology and outcomes of candidemia in 2019 patients: data from the Prospective Antifungal Therapy Alliance registry. Clin Infect Dis 48:1695–1703 [View Article][PubMed]
    [Google Scholar]
  15. Kocsubé S., Tóth M., Vágvölgyi C., Dóczi I., Pesti M., Pócsi I., Szabó J., Varga J. 2007; Occurrence and genetic variability of Candida parapsilosis sensu lato in Hungary. J Med Microbiol 56:190–195 [View Article][PubMed]
    [Google Scholar]
  16. Krcmery V., Barnes A. J. 2002; Non-albicans Candida spp. causing fungaemia: pathogenicity and antifungal resistance. J Hosp Infect 50:243–260 [View Article][PubMed]
    [Google Scholar]
  17. Lasker B. A., Butler G., Lott T. J. 2006; Molecular genotyping of Candida parapsilosis group I clinical isolates by analysis of polymorphic microsatellite markers. J Clin Microbiol 44:750–759 [View Article][PubMed]
    [Google Scholar]
  18. Leroy O., Gangneux J. P., Montravers P., Mira J. P., Gouin F., Sollet J. P., Carlet J., Reynes J., Rosenheim M. other authors 2009; Epidemiology, management, and risk factors for death of invasive Candida infections in critical care: a multicenter, prospective, observational study in France (2005–2006). Crit Care Med 37:1612–1618 [View Article][PubMed]
    [Google Scholar]
  19. Lida S., Imai T., Oguri T., Okuzumi K., Yamanaka A., Moretti-Branchini M. L., Nishimura K., Mikami Y. 2005; Genetic diversity of the internal transcribed spacers (ITS) and 5.8S rRNA genes among clinical isolates of Candida parapsilosis in Brazil and Japan. Nippon Ishinkin Gakkai Zasshi 46:133–137 [View Article]
    [Google Scholar]
  20. Lin D., Wu L.-C., Rinaldi M. G., Lehmann P. F. 1995; Three distinct genotypes within Candida parapsilosis from clinical sources. J Clin Microbiol 33:1815–1821[PubMed]
    [Google Scholar]
  21. Lockhart S. R., Messer S. A., Pfaller M. A., Diekema D. J. 2008; Geographic distribution and antifungal susceptibility of the newly described species Candida orthopsilosis and Candida metapsilosis in comparison to the closely related species Candida parapsilosis . J Clin Microbiol 46:2659–2664 [View Article][PubMed]
    [Google Scholar]
  22. Lopez J., Pernot C., Aho S., Caillot D., Vagner O., Dalle F., Durnet-Archeray M. J., Chavanet P., Bonnin A. 2001; Decrease in Candida albicans strains with reduced susceptibility to fluconazole following changes in prescribing policies. J Hosp Infect 48:122–128 [View Article][PubMed]
    [Google Scholar]
  23. Mirhendi H., Bruun B., Schønheyder H. C., Christensen J. J., Fuursted K., Gahrn-Hansen B., Johansen H. K., Nielsen L., Knudsen J. D., Arendrup M. C. 2010; Molecular screening for Candida orthopsilosis and Candida metapsilosis among Danish Candida parapsilosis group blood culture isolates: proposal of a new RFLP profile for differentiation. J Med Microbiol 59:414–420 [View Article][PubMed]
    [Google Scholar]
  24. Morgan J. 2005; Global trends in candidemia: review of reports from 1995–2005. Curr Infect Dis Rep 7:429–439 [View Article][PubMed]
    [Google Scholar]
  25. Moudgal V., Little T., Boikov D., Vazquez J. A. 2005; Multiechinocandin- and multiazole-resistant Candida parapsilosis isolates serially obtained during therapy for prosthetic valve endocarditis. Antimicrob Agents Chemother 49:767–769 [View Article][PubMed]
    [Google Scholar]
  26. Oxman D. A., Chow J. K., Frendl G., Hadley S., Hershkovitz S., Ireland P., McDermott L. A., Tsai K., Marty F. M. other authors 2010; Candidaemia associated with decreased in vitro fluconazole susceptibility: is Candida speciation predictive of the susceptibility pattern?. J Antimicrob Chemother 65:1460–1465 [View Article][PubMed]
    [Google Scholar]
  27. Pappas P. G., Kauffman C. A., Andes D., Benjamin D. K. Jr, Calandra T. F., Edwards J. E. Jr, Filler S. G., Fisher J. F., Kullberg B. J. other authors 2009; Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis 48:503–535 [View Article][PubMed]
    [Google Scholar]
  28. Pereira G. H., Müller P. R., Szeszs M. W., Levin A. S., Melhem M. S. 2010; Five-year evaluation of bloodstream yeast infections in a tertiary hospital: the predominance of non-C. albicans Candida species. Med Mycol 48:839–842 [View Article][PubMed]
    [Google Scholar]
  29. Pfaller M. A., Diekema D. J., Jones R. N., Sader H. S., Fluit A. C., Hollis R. J., Messer S. A. SENTRY Participant Group 2001; International surveillance of bloodstream infections due to Candida species: frequency of occurrence and in vitro susceptibilities to fluconazole, ravuconazole, and voriconazole of isolates collected from 1997 through 1999 in the SENTRY Antimicrobial Surveillance Program. J Clin Microbiol 39:3254–3259 [View Article][PubMed]
    [Google Scholar]
  30. Pfaller M. A., Messer S. A., Moet G. J., Jones R. N., Castanheira M. 2011; Candida bloodstream infections: comparison of species distribution and resistance to echinocandin and azole antifungal agents in Intensive Care Unit (ICU) and non-ICU settings in the SENTRY Antimicrobial Surveillance Program (2008–2009). Int J Antimicrob Agents 38:65–69 [View Article][PubMed]
    [Google Scholar]
  31. Pryce T. M., Palladino S., Price D. M., Gardam D. J., Campbell P. B., Christiansen K. J., Murray R. J. 2006; Rapid identification of fungal pathogens in BacT/ALERT, BACTEC, and BBL MGIT media using polymerase chain reaction and DNA sequencing of the internal transcribed spacer regions. Diagn Microbiol Infect Dis 54:289–297 [View Article][PubMed]
    [Google Scholar]
  32. Rex J. H., Pfaller M. A., Walsh T. J., Chaturvedi V., Espinel-Ingroff A., Ghannoum M. A., Gosey L. L., Odds F. C., Rinaldi M. G. other authors 2001; Antifungal susceptibility testing: practical aspects and current challenges. Clin Microbiol Rev 14:643–658 [View Article][PubMed]
    [Google Scholar]
  33. Rocco T. R., Reinert S. E., Simms H. H. 2000; Effects of fluconazole administration in critically ill patients: analysis of bacterial and fungal resistance. Arch Surg 135:160–165 [View Article][PubMed]
    [Google Scholar]
  34. Rodriguez-Tudela J. L., Arendrup M. C., Cuenca-Estrella M., Donnelly J. P., Lass-Flor C. 2010; EUCAST breakpoints for antifungals. Drug News Perspect 23:93–97 [View Article][PubMed]
    [Google Scholar]
  35. Shin J. H., Shin D. H., Song J. W., Kee S. J., Suh S. P., Ryang D. W. 2001; Electrophoretic karyotype analysis of sequential Candida parapsilosis isolates from patients with persistent or recurrent fungemia. J Clin Microbiol 39:1258–1263 [View Article][PubMed]
    [Google Scholar]
  36. Silva A. P., Miranda I. M., Lisboa C., Pina-Vaz C., Rodrigues A. G. 2009; Prevalence, distribution, and antifungal susceptibility profiles of Candida parapsilosis, C. orthopsilosis, and C. metapsilosis in a tertiary care hospital. J Clin Microbiol 47:2392–2397 [View Article][PubMed]
    [Google Scholar]
  37. Subcommittee on Antifungal Susceptibility Testing (AFST) of the ESCMID European Committee for Antimicrobial Susceptibility Testing (EUCAST) 2008; EUCAST definitive document EDef 7.1: method for the determination of broth dilution MICs of antifungal agents for fermentative yeasts. Clin Microbiol Infect 14:398–405 [View Article][PubMed]
    [Google Scholar]
  38. Tavanti A., Davidson A. D., Gow N. A., Maiden M. C., Odds F. C. 2005; Candida orthopsilosis and Candida metapsilosis spp. nov. to replace Candida parapsilosis groups II and III. J Clin Microbiol 43:284–292 [View Article][PubMed]
    [Google Scholar]
  39. Tavanti A., Hensgens L. A., Ghelardi E., Campa M., Senesi S. 2007; Genotyping of Candida orthopsilosis clinical isolates by amplification fragment length polymorphism reveals genetic diversity among independent isolates and strain maintenance within patients. J Clin Microbiol 45:1455–1462 [View Article][PubMed]
    [Google Scholar]
  40. Tay S. T., Na S. L., Chong J. 2009; Molecular differentiation and antifungal susceptibilities of Candida parapsilosis isolated from patients with bloodstream infections. J Med Microbiol 58:185–191 [View Article][PubMed]
    [Google Scholar]
  41. Tortorano A. M., Kibbler C., Peman J., Bernhardt H., Klingspor L., Grillot R. 2006; Candidaemia in Europe: epidemiology and resistance. Int J Antimicrob Agents 27:359–366 [View Article][PubMed]
    [Google Scholar]
  42. Trofa D., Gácser A., Nosanchuk J. D. 2008; Candida parapsilosis, an emerging fungal pathogen. Clin Microbiol Rev 21:606–625 [View Article][PubMed]
    [Google Scholar]
  43. van Asbeck E., Clemons K. V., Martinez M., Tong A.-J., Stevens D. A. 2008; Significant differences in drug susceptibility among species in the Candida parapsilosis group. Diagn Microbiol Infect Dis 62:106–109 [View Article][PubMed]
    [Google Scholar]
  44. Wey S. B., Mori M., Pfaller M. A., Woolson R. F., Wenzel R. P. 1988; Hospital-acquired candidemia. The attributable mortality and excess length of stay. Arch Intern Med 148:2642–2645 [View Article][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.037812-0
Loading
/content/journal/jmm/10.1099/jmm.0.037812-0
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error