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. 2020 Feb 19;12(1):16-20.
doi: 10.4103/jgid.jgid_74_19. eCollection 2020 Jan-Mar.

Persistence of Clonal Azole-Resistant Isolates of Candida albicans from a Patient with Chronic Mucocutaneous Candidiasis in Colombia

Andrés Ceballos-Garzon  1   2   3 , Luz M Wintaco-Martínez  4 , Norida Velez  1 , Catalina Hernandez-Padilla  2 , Alejandro De la Hoz  2 , Sandra Liliana Valderrama-Beltrán  2 , Carlos A Alvarez-Moreno  2 , Patrice Le Pape  3 , Juan David Ramírez  4 , Claudia M Parra-Giraldo  1   2
Affiliations

Persistence of Clonal Azole-Resistant Isolates of Candida albicans from a Patient with Chronic Mucocutaneous Candidiasis in Colombia

Andrés Ceballos-Garzon et al. J Glob Infect Dis. .

Abstract

Purpose: The present article describes retrospectively a case of a patient with chronic mucocutaneous candidiasis (CMC) who presented recurrent Candida albicans infection since he was 6 months old. We obtained 16 isolates recovered during a 4-year period. Our purpose was to determinate the susceptibility, genotyping, and the pathogenicity profile in all the isolates.

Methods: Sixteen C. albicans were isolated from a 25-year-old male with several recurrent fungal infections admitted to Hospital. The isolates were recovered during 4 years from a different anatomical origin. We typified them by multilocus sequence typing, also we evaluated susceptibility to fluconazole, itraconazole, voriconazole, posaconazole, isavuconazole, caspofungin, and amphotericin B by microdilution method and we also test the pathogenic capacity in the Galleria mellonella model.

Results: Genotyping of all clinical isolates showed the persistence of the same diploid sequence type (DST). Isolates changed their susceptibility profile over time, but there were no significant statistical differences in pathogenicity.

Conclusion: Herein, a persistent clonal isolates of C. albicans (DST 918) in a patient with CMC, showed changes in its susceptibility profile after several antifungal treatments acquiring gradual resistance to the azole drugs, which did not affect their pathogenicity.

Keywords: chronic mucocutaneous candidiasis; multilocus sequence typing; Candida albicans; Galleria mellonella; drug susceptibility.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Patient's lesion and eBURST diagram. (a) Lesions of chronic mucocutaneous candidiasis patient: White cotton-like plaques widely distributed in the oral cavity, hypertrophic mucosa, and cheilitis. (b) The illustration shows the figure generated by eBURST 3.0 software, in which diploid sequence types are linked when they differ in the sequence of just one of the seven gene fragments used for MLST. The lengths of lines are not significant. The lines indicate differences between diploid sequence types that result from a loss of heterozygosity from the putative parent to the putative-derived isolate or from mutation, gene exchange, or another mechanism
Figure 2
Figure 2
Characteristics of Candida spp. isolates. (a) Antifungal treatment over time. (b) Antifungal susceptibility results
Figure 3
Figure 3
Survival curve of average according to anatomical origin. Kaplan–Meier plots of Galleria mellonella survival after infection with Candida albicans 3.105 UFC/ml. inside the brackets the number of samples
See this image and copyright information in PMC

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