Molecular Identification, Genotypic Diversity, Antifungal Susceptibility, and Clinical Outcomes of Infections Caused by Clinically Underrated Yeasts, Candida orthopsilosis, and Candida metapsilosis: An Iranian Multicenter Study (2014–2019)

Arastehfar, A. and Khodavaisy, S. and Daneshnia, F. and Najafzadeh, M. J. and Mahmoudi, S. and Charsizadeh, A. and Salehi, M. R. and Zarrinfar, H. and Raeisabadi, A. and Dolatabadi, S. and Zare Shahrabadi, Z. and Zomorodian, K. and Pan, W. and Hagen, F. and Boekhout, T. (2019) Molecular Identification, Genotypic Diversity, Antifungal Susceptibility, and Clinical Outcomes of Infections Caused by Clinically Underrated Yeasts, Candida orthopsilosis, and Candida metapsilosis: An Iranian Multicenter Study (2014–2019). Frontiers in Cellular and Infection Microbiology, 9.

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Molecular Identification, Genotypic Diversity, Antifungal Susceptibility, and Clinical Outcomes of Infections Caused by Clinically Underrated Yeasts, Candida orthopsilosis, and Candida metapsilosis.pdf

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Abstract

Despite the increasing occurrence of Candida orthopsilosis and Candida metapsilosis in clinical settings, little is known about their microbiological and clinical properties. Herein, we conducted a national retrospective study (2014–2019) from multiple centers in Iran. Among the 1,770 Candida isolates collected, we identified 600 Candida parapsilosis species complex isolates. Isolate identification was performed by 9-plex PCR, matrix-assisted laser desorption-time of flight mass spectrometry (MALDI-TOF MS), and rDNA sequencing, and antifungal susceptibility testing (AFST) followed CLSI M27-A3/S4; genotyping was performed by amplified fragment length polymorphism (AFLP) analysis; and clinical information was mined. Thirty-one isolates of C. orthopsilosis from various clinical sources, one mixed sample (blood) concurrently containing C. orthopsilosis and C. parapsilosis and one isolate of C. metapsilosis from a nail sample were identified. Although both 9-plex PCR and MALDI-TOF successfully identified all isolates, only 9-plex PCR could identify the agents in a mixed sample. For the C. orthopsilosis isolates, resistance (non-wild type) was noted only for itraconazole (n = 4; 12.5). Anidulafungin and fluconazole showed the highest and voriconazole had the lowest geometric mean values. AFLP analysis showed three main and four minor genotypes. Interestingly, 90 of nail isolates clustered with 80 of the blood isolates within two clusters, and four blood isolates recovered from four patients admitted to a hospital clustered into two genotypes and showed a high degree of similarity (>99.2), which suggests that C. orthopsilosis disseminates horizontally. Supported by our data and published case studies, C. orthopsilosis and C. metapsilosis can be linked to challenging clinical failures, and successful outcomes are not always mirrored by in vitro susceptibility. Accordingly, conducting nationwide studies may provide more comprehensive data, which is required for a better prognosis and clinical management of patients. © Copyright © 2019 Arastehfar, Khodavaisy, Daneshnia, Najafzadeh, Mahmoudi, Charsizadeh, Salehi, Zarrinfar, Raeisabadi, Dolatabadi, Zare Shahrabadi, Zomorodian, Pan, Hagen and Boekhout.

Item Type: Article
Additional Information: Export Date: 16 February 2020 Correspondence Address: Zomorodian, K.; Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical SciencesIran; email: zomorodian@sums.ac.ir
Uncontrolled Keywords: AFLP genotyping AFST C. metapsilosis C. orthopsilosis C. parapsilosis species complex clonality Iran amphotericin B anidulafungin caspofungin echinocandin fluconazole internal transcribed spacer itraconazole micafungin pyrrole derivative ribosome DNA voriconazole acute lymphoblastic leukemia acute myeloid leukemia adult aged amplified fragment length polymorphism antifungal susceptibility Article Candida albicans Candida metapsilosis Candida orthopsilosis candidiasis child clinical article clinical outcome diabetes mellitus DNA extraction DNA sequence ERG11 gene female FKS1 gene fungal strain fungus identification gene genotype hematologic malignancy human lung embolism male matrix assisted laser desorption ionization time of flight mass spectrometry MIC50 MIC90 microbial diversity mortality multicenter study nonhuman phenotype phylogenetic tree pneumonia point mutation polymerase chain reaction vaginitis
Subjects: QW Microbiology and Immunology
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib1 lib1
Date Deposited: 20 Jun 2020 09:11
Last Modified: 20 Jun 2020 09:11
URI: http://eprints.mums.ac.ir/id/eprint/18259

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