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Emergence of clonal fluconazole-resistant Candida parapsilosis clinical isolates in a multicentre laboratory-based surveillance study in India

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. Methods 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. Results 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

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