Molecular Identification and Antifungal Susceptibility of Yeast Isolates Causing Fungemia Collected in a Population-Based Study in Spain in 2010 and 2011
Por:
Guinea, J, Zaragoza, O, Escribano, P, Martin-Mazuelos, E, Peman, J, Sanchez-Reus, F, Cuenca-Estrella, M
Publicada:
1 mar 2014
Resumen:
We report the molecular identifications and antifungal susceptibilities of the isolates causing fungemia collected in the CANDIPOP population-based study conducted in 29 Spanish hospitals. A total of 781 isolates (from 767 patients, 14 of them having mixed fungemia) were collected. The species found most frequently were Candida albicans (44.6%), Candida parapsilosis (24.5%), Candida glabrata (13.2%), Candida tropicalis (7.6%), Candida krusei (1.9%), Candida guilliermondii (1.7%), and Candida lusitaniae (1.3%). Other Candida and non-Candida species accounted for approximately 5% of the isolates. The presence of cryptic species was low. Compared to findings of previous studies conducted in Spain, the frequency of C. glabrata has increased. Antifungal susceptibility testing was performed by using EUCAST and CLSI M27-A3 reference procedures; the two methods were comparable. The rate of fluconazole-susceptible isolates was 80%, which appears to be a decrease compared to findings of previous studies, explained mainly by the higher frequency of C. glabrata. Using the species-specific breakpoints and epidemiological cutoff values, the rate of voriconazole and posaconazole in vitro resistance was low (<2%). In the case of C. tropicalis, using the EUCAST procedure, the rate of azole resistance was around 20%. There was a correlation between the previous use of azoles and the presence of fluconazole-resistant isolates. Resistance to echinocandins was very rare (2%), and resistance to amphotericin B also was very uncommon. The sequencing of the hot spot (HS) regions from FKS1 or FKS2 genes in echinocandin-resistant isolates revealed previously described point mutations. The decrease in the susceptibility to fluconazole in Spanish isolates should be closely monitored in future studies.
Filiaciones:
Guinea, J:
Univ Complutense Madrid, Hosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis Dept, Madrid, Spain
Hosp Gregorio Maranon, Inst Invest Sanitaria, Madrid, Spain
CIBER Enfermedades Resp, CIBER RES CD06 06 0058, Palma De Mallorca, Spain
Univ Complutense Madrid, Sch Med, Dept Med, Madrid, Spain
Zaragoza, O:
Inst Salud Carlos III, Natl Ctr Microbiol, Mycol Reference Lab, Madrid, Spain
Escribano, P:
Univ Complutense Madrid, Hosp Gen Univ Gregorio Maranon, Clin Microbiol & Infect Dis Dept, Madrid, Spain
Hosp Gregorio Maranon, Inst Invest Sanitaria, Madrid, Spain
CIBER Enfermedades Resp, CIBER RES CD06 06 0058, Palma De Mallorca, Spain
Martin-Mazuelos, E:
Hosp Univ Valme, Clin Microbiol & Infect Dis Unit, Seville, Spain
Inst Biomed Sevilla IBIS, Seville, Spain
Peman, J:
Hosp Univ & Politecn La Fe, Dept Clin Microbiol, Valencia, Spain
Cuenca-Estrella, M:
Inst Salud Carlos III, Natl Ctr Microbiol, Mycol Reference Lab, Madrid, Spain
Hosp Santa Creu & Sant Pau, Microbiol Serv, Barcelona, Spain
Univ Autonoma Barcelona, Dept Genet & Microbiol, E-08193 Barcelona, Spain
Green Published, Bronze
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