Publication Type : Journal Article
Thematic Areas : Medical Sciences
Publisher : Journal of Antimicrobial Chemotherapy,
Source : Journal of Antimicrobial Chemotherapy, Volume 74, Issue 5, 2019
Url : https://academic.oup.com/jac/article/74/5/1260/5315659
Campus : Kochi
School : School of Medicine
Department : Microbiology
Year : 2019
Abstract : Objectives
The emergence of fluconazole resistance in Candida parapsilosis healthcare-associated infections has recently been increasingly reported. Antifungal susceptibility profiles and mechanisms of fluconazole resistance in C. parapsilosis (n = 199) from nine hospitals in India collected over a period of 3 years were studied. Further, clonal transmission of fluconazole-resistant isolates in different hospitals was investigated.
Antifungal susceptibility testing of five azoles, amphotericin B and 5-flucytosine was performed by the CLSI microbroth dilution method. The azole target ERG11 gene was sequenced, and the significance of a novel ERG11 mutation in C. parapsilosis was determined using a gap-repair cloning approach in Saccharomyces cerevisiae. In addition, microsatellite analysis was performed to determine the clonal lineage of C. parapsilosis-resistant strains circulating among different hospitals.
A total of 64 (32%) C. parapsilosis isolates were non-susceptible to fluconazole, which included resistant (n = 55; MIC >4 mg/L) and susceptible dose-dependent (n = 9) isolates. Of these 64 non-susceptible isolates, a novel K143R amino acid substitution was noted in 92%, and the remaining five isolates had the Y132F substitution. Elevated azole MICs (≥16-fold) were detected in S. cerevisiae upon expression of C. parapsilosis ERG11 alleles carrying Y132F or K143R substitutions. Two major clusters of non-susceptible isolates were circulating in seven Indian hospitals.
Cite this Research Publication : Ashutosh Singh, Pradeep K Singh, Theun de Groot, Anil Kumar, Purva Mathur, Bansidhar Tarai, Neelam Sachdeva, Gargi Upadhyaya, Smita Sarma, Jacques F Meis, Anuradha Chowdhary "Emergence of clonal fluconazole-resistant Candida parapsilosis clinical isolates in a multicentre laboratory-based surveillance study in India", Journal of Antimicrobial Chemotherapy, 2019