Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun 4;8(2):58-66.
doi: 10.18683/germs.2018.1132. eCollection 2018 Jun.

Phenotypic typing and epidemiological survey of antifungal resistance of Candida species detected in clinical samples of Italian patients in a 17 months' period

Margherita Scapaticci  1 , Andrea Bartolini  2 , Federica Del Chierico  3 , Cristel Accardi  4 , Francesco Di Girolamo  4 , Andrea Masotti  5 , Maurizio Muraca  6 , Lorenza Putignani  7
Affiliations

Phenotypic typing and epidemiological survey of antifungal resistance of Candida species detected in clinical samples of Italian patients in a 17 months' period

Margherita Scapaticci et al. Germs. .

Abstract

Introduction: Yeast pathogens are emerging agents of nosocomial as well as community-acquired infections and their rapid and accurate identification is crucial for a better management of high-risk patients and for an adequate treatment.

Methods: We performed a retrospective review of 156 yeast isolates collected during a 17 months' period of regular clinical practice at the Microbiology Department of San Camillo Hospital in Treviso, Italy and analyzed by the traditional culture-based method combined with matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS).

Results: Out of all the samples collected MALDI-TOF MS was able to characterize with a MT score ≥1.7 (accurate result at species level) 12 different yeast and yeast-like species from 140 samples: Candida albicans (63.7%), Candida glabrata (13.6%), Saccharomyces cerevisiae (6.5%), Candida parapsilosis (5.7%), Candida tropicalis (2.1%), Candida pararugosa (2.1%), Candida guilliermondii (2.1%), Candida kefyr (1.4%), Candida lusitaniae (0.7%), Candida palmioleophila (0.7%), Geotrichum silvicola (0.7%), Rhodotorula mucilaginosa (0.7%). Susceptibility testing toward seven common antifungal agents showed a characteristic MIC distribution of C. albicans isolates for echinocandins: particularly we noticed that 72% and 46% of C. albicans showed an MIC value close to clinical breakpoint as defined by EUCAST, respectively for anidulafungin and micafungin.

Conclusion: Accurate identification of microorganisms and the study of their antifungal susceptibility allow to understand the epidemiology of a particular area, permitting the choice of the most appropriate early antifungal treatment.

Keywords: MALDI-TOF MS; Yeast infection; antifungal resistance.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest: All authors – none to disclose.

Figures

Figure 1.
Figure 1.. Graphical distribution of Candida spp. isolates collected from August 2013 to November 2014 (N=156)
The strains are grouped on the basis of collection date (Panel A), sample type (Panel B), ward distribution (Panel C), and species distribution by traditional ID methods (Panel D).
Figure 2.
Figure 2.. MALDI-TOF MS spectra of the 12 yeast and yeast-like species identified by MT ID originated by MALDI Biotyper Software analysis
The m/z values are expressed in Da and the amplitudes are reported in a scale of intensity arbitrary units (a.u.). The MT IS score was in all cases >1.7.
Figure 3.
Figure 3.. MIC distribution of echinocandins for Candida albicans isolates (N=89)
The arrows indicate EUCAST Clinical Breakpoint (CB) and epidemiological cut-off values (ECOFF) for micafungin (Panel A) and anidulafungin (Panel B).
See this image and copyright information in PMC

References

    1. Pappas PG, Kauffman CA, Andes D, et al. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;48:503–35. - PMC - PubMed
    1. Sullivan DJ, Coleman DC. Candida dubliniensis: characteristics and identification. J Clin Microbiol. 1998;31:329–34. - PMC - PubMed
    1. Ben-Ami R, Berman J, Novikov A, et al. Multidrug-resistant Candida haemulonii and C. auris, Tel Aviv, Israel. Emerg Infect Dis. 2017;23:195–203. - PMC - PubMed
    1. Fell JW, Boekhout T, Fonseca A, Scorzetti G, Statzell-Tallman A. Biodiversity and systematics of basidiomycetous yeasts as determined by large-subunit rDNA D1/D2 domain sequence analysis. Int J Syst Evol Microbiol. 2000;50(Pt3):1351–71. - PubMed
    1. Cornely OA, Bassetti M, Calandra T, et al. ESCMID guideline for the diagnosis and management of Candida diseases 2012: non-neutropenic adult patients. Clin Microbiol Infect. 2012;18(Suppl 7):19–37. - PubMed

LinkOut - more resources