Molecular identification, antifungal susceptibility, and resistance mechanisms of pathogenic yeasts from the China antifungal resistance surveillance trial (CARST-fungi) study
To have a comprehensive understanding of epidemiology and antifungal susceptibilities in pathogenic yeasts, the China Antifungal Resistance Surveillance Trial (CARST-fungi) study was conducted. All yeast isolates were identified by ribosomal DNA sequencing. Antifungal susceptibilities were performed...
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Frontiers Media S.A.
2022-10-01
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| Series: | Frontiers in Microbiology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2022.1006375/full |
| _version_ | 1828107320991678464 |
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| author | Qiqi Wang Xuan Cai Yun Li Jianhong Zhao Zhiyong Liu Yan Jiang Ling Meng Yanming Li Shiyang Pan Xiaoman Ai Fang Zhang Ruoyu Li Bo Zheng Zhe Wan Wei Liu |
| author_facet | Qiqi Wang Xuan Cai Yun Li Jianhong Zhao Zhiyong Liu Yan Jiang Ling Meng Yanming Li Shiyang Pan Xiaoman Ai Fang Zhang Ruoyu Li Bo Zheng Zhe Wan Wei Liu |
| author_sort | Qiqi Wang |
| collection | DOAJ |
| description | To have a comprehensive understanding of epidemiology and antifungal susceptibilities in pathogenic yeasts, the China Antifungal Resistance Surveillance Trial (CARST-fungi) study was conducted. All yeast isolates were identified by ribosomal DNA sequencing. Antifungal susceptibilities were performed using CLSI M27-A4 broth microdilution method. Sequence and expression level of resistant-related genes in resistant/non-wide-type (NWT) Candida isolates were analyzed. Totally 269 nonduplicate yeast isolates from 261 patients were collected. About half of the yeast isolates (127, 47.2%) were recovered from blood, followed by ascetic fluid (46, 17.1%). C. albicans remained the most prevalent (120, 44.6%), followed by C. parapsilosis complex (50, 18.6%), C. tropicalis (40, 14.9%), and C. glabrata (36, 13.4%). Fourteen (11.7%) C. albicans isolates and 1 (2.0%) C. parapsilosis isolate were resistant/NWT to triazoles. Only 42.5% (17/40) C. tropicalis were susceptible/WT to all the triazoles, with 19 (47.5%) isolates NWT to posaconazole and 8 (20%) cross-resistant to triazoles. Among C. glabrata, 20 (55.6%) and 8 (22.2%) isolates were resistant/NWT to voriconazole and posaconazole, respectively, and 4 (10.3%) isolates were cross-resistant to triazoles. Isavuconazole was the most active triazole against common Candida isolates. Except for 2 isolates of C. glabrata cross-resistant to echinocandins which were also NWT to POS and defined as multidrug-resistant, echinocandins exhibit good activity against common Candida species. All isolates were WT to AMB. For less common species, Rhodotorula mucilaginosa exhibited high MICs to echinocandins and FLC, and 1 isolate of Trichosporon asahii showed high MICs to all the antifungals except AMB. Among triazole-resistant Candida isolates, ERG11 mutations were detected in 10/14 C. albicans and 6/23 C. tropicalis, while 21/23 C. tropicalis showed MDR1 overexpression. Overexpression of CDR1, CDR2, and SNQ2 exhibited in 14, 13, and 8 of 25 triazole-resistant C. glabrata isolates, with 5 isolates harboring PDR1 mutations and 2 echinocandins-resistant isolates harboring S663P mutation in FKS2. Overall, the CARST-fungi study demonstrated that although C. albicans remain the most predominant species, non-C. albicans species accounted for a high proportion. Triazole-resistance is notable among C. tropicalis and C. glabrata. Multidrug-resistant isolates of C. glabrata and less common yeast have been emerging. |
| first_indexed | 2024-04-11T10:29:21Z |
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| series | Frontiers in Microbiology |
| spelling | doaj.art-7d928898b95248eea68eab30e826b1ff2022-12-22T04:29:28ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2022-10-011310.3389/fmicb.2022.10063751006375Molecular identification, antifungal susceptibility, and resistance mechanisms of pathogenic yeasts from the China antifungal resistance surveillance trial (CARST-fungi) studyQiqi Wang0Xuan Cai1Yun Li2Jianhong Zhao3Zhiyong Liu4Yan Jiang5Ling Meng6Yanming Li7Shiyang Pan8Xiaoman Ai9Fang Zhang10Ruoyu Li11Bo Zheng12Zhe Wan13Wei Liu14Department of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University, Beijing, ChinaDepartment of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, ChinaInstitute of Clinical Pharmacology, Peking University First Hospital, Beijing, ChinaDepartment of Clinical Laboratory Medicine, Second Hospital of Hebei Medical University, Shijiazhuang, ChinaDepartment of Laboratory Medicine, Southwest Hospital, Army Medical University, Chongqing, ChinaCenter for Clinical Laboratories, Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaLanzhou University Second Hospital, Lanzhou, ChinaDepartment of Clinical Laboratory, Xiangya Hospital, Central South University, Changsha, ChinaFirst Affiliated Hospital of Nanjing Medical University, Nanjing, China0Department of Medical Laboratory, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China1Medical Research and Laboratory Diagnostic Center, Central Hospital Affiliated to Shandong First Medical University, Jinan, ChinaDepartment of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University, Beijing, ChinaInstitute of Clinical Pharmacology, Peking University First Hospital, Beijing, ChinaDepartment of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University, Beijing, ChinaDepartment of Dermatology and Venereology, Peking University First Hospital, National Clinical Research Center for Skin and Immune Diseases, Research Center for Medical Mycology, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Peking University, Beijing, ChinaTo have a comprehensive understanding of epidemiology and antifungal susceptibilities in pathogenic yeasts, the China Antifungal Resistance Surveillance Trial (CARST-fungi) study was conducted. All yeast isolates were identified by ribosomal DNA sequencing. Antifungal susceptibilities were performed using CLSI M27-A4 broth microdilution method. Sequence and expression level of resistant-related genes in resistant/non-wide-type (NWT) Candida isolates were analyzed. Totally 269 nonduplicate yeast isolates from 261 patients were collected. About half of the yeast isolates (127, 47.2%) were recovered from blood, followed by ascetic fluid (46, 17.1%). C. albicans remained the most prevalent (120, 44.6%), followed by C. parapsilosis complex (50, 18.6%), C. tropicalis (40, 14.9%), and C. glabrata (36, 13.4%). Fourteen (11.7%) C. albicans isolates and 1 (2.0%) C. parapsilosis isolate were resistant/NWT to triazoles. Only 42.5% (17/40) C. tropicalis were susceptible/WT to all the triazoles, with 19 (47.5%) isolates NWT to posaconazole and 8 (20%) cross-resistant to triazoles. Among C. glabrata, 20 (55.6%) and 8 (22.2%) isolates were resistant/NWT to voriconazole and posaconazole, respectively, and 4 (10.3%) isolates were cross-resistant to triazoles. Isavuconazole was the most active triazole against common Candida isolates. Except for 2 isolates of C. glabrata cross-resistant to echinocandins which were also NWT to POS and defined as multidrug-resistant, echinocandins exhibit good activity against common Candida species. All isolates were WT to AMB. For less common species, Rhodotorula mucilaginosa exhibited high MICs to echinocandins and FLC, and 1 isolate of Trichosporon asahii showed high MICs to all the antifungals except AMB. Among triazole-resistant Candida isolates, ERG11 mutations were detected in 10/14 C. albicans and 6/23 C. tropicalis, while 21/23 C. tropicalis showed MDR1 overexpression. Overexpression of CDR1, CDR2, and SNQ2 exhibited in 14, 13, and 8 of 25 triazole-resistant C. glabrata isolates, with 5 isolates harboring PDR1 mutations and 2 echinocandins-resistant isolates harboring S663P mutation in FKS2. Overall, the CARST-fungi study demonstrated that although C. albicans remain the most predominant species, non-C. albicans species accounted for a high proportion. Triazole-resistance is notable among C. tropicalis and C. glabrata. Multidrug-resistant isolates of C. glabrata and less common yeast have been emerging.https://www.frontiersin.org/articles/10.3389/fmicb.2022.1006375/fullpathogenic yeastsinvasive fungal diseasesCandida spp.antifungal susceptibilitytriazolesechinocandins |
| spellingShingle | Qiqi Wang Xuan Cai Yun Li Jianhong Zhao Zhiyong Liu Yan Jiang Ling Meng Yanming Li Shiyang Pan Xiaoman Ai Fang Zhang Ruoyu Li Bo Zheng Zhe Wan Wei Liu Molecular identification, antifungal susceptibility, and resistance mechanisms of pathogenic yeasts from the China antifungal resistance surveillance trial (CARST-fungi) study Frontiers in Microbiology pathogenic yeasts invasive fungal diseases Candida spp. antifungal susceptibility triazoles echinocandins |
| title | Molecular identification, antifungal susceptibility, and resistance mechanisms of pathogenic yeasts from the China antifungal resistance surveillance trial (CARST-fungi) study |
| title_full | Molecular identification, antifungal susceptibility, and resistance mechanisms of pathogenic yeasts from the China antifungal resistance surveillance trial (CARST-fungi) study |
| title_fullStr | Molecular identification, antifungal susceptibility, and resistance mechanisms of pathogenic yeasts from the China antifungal resistance surveillance trial (CARST-fungi) study |
| title_full_unstemmed | Molecular identification, antifungal susceptibility, and resistance mechanisms of pathogenic yeasts from the China antifungal resistance surveillance trial (CARST-fungi) study |
| title_short | Molecular identification, antifungal susceptibility, and resistance mechanisms of pathogenic yeasts from the China antifungal resistance surveillance trial (CARST-fungi) study |
| title_sort | molecular identification antifungal susceptibility and resistance mechanisms of pathogenic yeasts from the china antifungal resistance surveillance trial carst fungi study |
| topic | pathogenic yeasts invasive fungal diseases Candida spp. antifungal susceptibility triazoles echinocandins |
| url | https://www.frontiersin.org/articles/10.3389/fmicb.2022.1006375/full |
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