Multilocus sequence typing of azole-resistant Candida auris strains, South Africa
Background: Candida auris is an emerging multidrug-resistant fungal pathogen associated with high mortality. Methods: We investigated the genetic relatedness of clinical C. auris isolates from patients admitted to either public- or private-sector hospitals, which were submitted to a reference labor...
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| Format: | Article |
| Language: | English |
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AOSIS
2020-03-01
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| Series: | Southern African Journal of Infectious Diseases |
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| Online Access: | https://sajid.co.za/index.php/sajid/article/view/116 |
| _version_ | 1818756233352445952 |
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| author | Rindidzani Magobo Mabatho Mhlanga Craig Corcoran Nelesh P. Govender |
| author_facet | Rindidzani Magobo Mabatho Mhlanga Craig Corcoran Nelesh P. Govender |
| author_sort | Rindidzani Magobo |
| collection | DOAJ |
| description | Background: Candida auris is an emerging multidrug-resistant fungal pathogen associated with high mortality.
Methods: We investigated the genetic relatedness of clinical C. auris isolates from patients admitted to either public- or private-sector hospitals, which were submitted to a reference laboratory from 2012 to 2015. Patient demographics and clinical details were recorded. We performed antifungal susceptibility testing, sequencing of the hotspot 1 and 2 regions of the FKS1 and FKS2 genes for all isolates with an echinocandin minimum inhibitory concentration (MIC) of ≥1 µg/mL and cluster analysis using multilocus sequence typing.
Results: Eighty-five isolates were confirmed as C. auris. The median patient age was 59 years [inter-quartile range (IQR): 48–68 years], with male patients accounting for 68% of cases. Specimen types included urine (29%), blood (27%), central venous catheter tips (25%), irrigation fluid (7%), tissue (5%), respiratory tract specimens (4%) and other (3%). Ninety-seven per cent of isolates were resistant to fluconazole, 7% were resistant to both fluconazole and voriconazole, 8% were resistant to both fluconazole and echinocandins (considered multidrug resistant) and all were susceptible to amphotericin B. Of the 15 randomly selected fluconazole-resistant isolates, 14 isolates had an isavuconazole MIC ≤ 1 µg/mL. No FKS mutations were detected. Multilocus sequence typing (MLST) analysis grouped isolates into two clusters: cluster 1 and cluster 2 comprising 83 and 2 isolates, respectively.
Conclusions: Azole-resistant C. auris strains circulating in South African hospitals were related by MLST, but the possibility of nosocomial transmission should be explored using a more discriminatory technique, for example, whole genome sequencing. |
| first_indexed | 2024-12-18T05:51:47Z |
| format | Article |
| id | doaj.art-754bd2fb34e3428b8c16f1d4d31a7801 |
| institution | Directory Open Access Journal |
| issn | 2312-0053 2313-1810 |
| language | English |
| last_indexed | 2024-12-18T05:51:47Z |
| publishDate | 2020-03-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Southern African Journal of Infectious Diseases |
| spelling | doaj.art-754bd2fb34e3428b8c16f1d4d31a78012022-12-21T21:18:53ZengAOSISSouthern African Journal of Infectious Diseases2312-00532313-18102020-03-01351e1e710.4102/sajid.v35i1.116138Multilocus sequence typing of azole-resistant Candida auris strains, South AfricaRindidzani Magobo0Mabatho Mhlanga1Craig Corcoran2Nelesh P. Govender3Centre for Healthcare-associated Infections, Antimicrobial Resistance and Mycoses, Division of the National Health Laboratory Service, National Institute for Communicable Diseases, Johannesburg, South Africa; and Ampath National Reference Laboratory, PretoriaCentre for Healthcare-associated Infections, Antimicrobial Resistance and Mycoses, Division of the National Health Laboratory Service, National Institute for Communicable Diseases, JohannesburgAmpath National Reference Laboratory, PretoriaCentre for Healthcare-associated Infections, Antimicrobial Resistance and Mycoses, Division of the National Health Laboratory Service, National Institute for Communicable Diseases, JohannesburgBackground: Candida auris is an emerging multidrug-resistant fungal pathogen associated with high mortality. Methods: We investigated the genetic relatedness of clinical C. auris isolates from patients admitted to either public- or private-sector hospitals, which were submitted to a reference laboratory from 2012 to 2015. Patient demographics and clinical details were recorded. We performed antifungal susceptibility testing, sequencing of the hotspot 1 and 2 regions of the FKS1 and FKS2 genes for all isolates with an echinocandin minimum inhibitory concentration (MIC) of ≥1 µg/mL and cluster analysis using multilocus sequence typing. Results: Eighty-five isolates were confirmed as C. auris. The median patient age was 59 years [inter-quartile range (IQR): 48–68 years], with male patients accounting for 68% of cases. Specimen types included urine (29%), blood (27%), central venous catheter tips (25%), irrigation fluid (7%), tissue (5%), respiratory tract specimens (4%) and other (3%). Ninety-seven per cent of isolates were resistant to fluconazole, 7% were resistant to both fluconazole and voriconazole, 8% were resistant to both fluconazole and echinocandins (considered multidrug resistant) and all were susceptible to amphotericin B. Of the 15 randomly selected fluconazole-resistant isolates, 14 isolates had an isavuconazole MIC ≤ 1 µg/mL. No FKS mutations were detected. Multilocus sequence typing (MLST) analysis grouped isolates into two clusters: cluster 1 and cluster 2 comprising 83 and 2 isolates, respectively. Conclusions: Azole-resistant C. auris strains circulating in South African hospitals were related by MLST, but the possibility of nosocomial transmission should be explored using a more discriminatory technique, for example, whole genome sequencing.https://sajid.co.za/index.php/sajid/article/view/116candida aurisazole resistantmultilocus sequence typingfks sequencingsouth africa. |
| spellingShingle | Rindidzani Magobo Mabatho Mhlanga Craig Corcoran Nelesh P. Govender Multilocus sequence typing of azole-resistant Candida auris strains, South Africa Southern African Journal of Infectious Diseases candida auris azole resistant multilocus sequence typing fks sequencing south africa. |
| title | Multilocus sequence typing of azole-resistant Candida auris strains, South Africa |
| title_full | Multilocus sequence typing of azole-resistant Candida auris strains, South Africa |
| title_fullStr | Multilocus sequence typing of azole-resistant Candida auris strains, South Africa |
| title_full_unstemmed | Multilocus sequence typing of azole-resistant Candida auris strains, South Africa |
| title_short | Multilocus sequence typing of azole-resistant Candida auris strains, South Africa |
| title_sort | multilocus sequence typing of azole resistant candida auris strains south africa |
| topic | candida auris azole resistant multilocus sequence typing fks sequencing south africa. |
| url | https://sajid.co.za/index.php/sajid/article/view/116 |
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