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. 2024 Mar;67(3):e13706.
doi: 10.1111/myc.13706.

Fluconazole-resistant Candida parapsilosis genotypes from hospitals located in five Spanish cities and one in Italy: Description of azole-resistance profiles associated with the Y132F ERG11p substitution

Aina Mesquida  1   2 , Eva Alcoceba  3 , Eduardo Padilla  4 , Aída Ramírez  5 , Paloma Merino  6   7 , Fernando González-Romo  6   7 , Elena De Carolis  8 , Maurizio Sanguinetti  8 , María de Los Ángeles Mantecón-Vallejo  9 , María Muñoz-Algarra  10 , Teresa Durán-Valle  11 , Ana Pérez-Ayala  12   13 , Elia Gómez-García-de-la-Pedrosa  14   15   16 , María Del Carmen Martínez-Jiménez  17 , Miguel Ángel Sánchez-Castellano  17 , Inmaculada Quiles-Melero  18 , María Soledad Cuétara  19 , Aída Sánchez-García  20 , Patricia Muñoz  1   2   21   22 , Pilar Escribano  1   2   23 , Jesús Guinea  1   2   21   23 ; CANDIMAD study group
Affiliations

Fluconazole-resistant Candida parapsilosis genotypes from hospitals located in five Spanish cities and one in Italy: Description of azole-resistance profiles associated with the Y132F ERG11p substitution

Aina Mesquida et al. Mycoses. 2024 Mar.

Abstract

Background: Fluconazole-resistant Candida parapsilosis is a matter of concern.

Objectives: To describe fluconazole-resistant C. parapsilosis genotypes circulating across hospitals in Spain and Rome and to study their azole-resistance profile associated with ERG11p substitutions.

Patients/methods: We selected fluconazole-resistant C. parapsilosis isolates (n = 528 from 2019 to 2023; MIC ≥8 mg/L according to EUCAST) from patients admitted to 13 hospitals located in five Spanish cities and Rome. Additionally, we tested voriconazole, posaconazole, isavuconazole, amphotericin B, micafungin, anidulafungin and ibrexafungerp susceptibility.

Results: Of the 53 genotypes found, 49 harboured the Y132F substitution, five of which were dominating city-specific genotypes involving almost half the isolates. Another genotype involved isolates harbouring the G458S substitution. Finally, we found two genotypes with the wild-type ERG11 gene sequence and one with the R398I substitution. All isolates were fully susceptible/wild-type to amphotericin B, anidulafungin, micafungin and ibrexafungerp. The azole-resistance patterns found were: voriconazole-resistant (74.1%) or voriconazole-intermediate (25.2%), posaconazole-resistant (10%) and isavuconazole non-wild-type (47.5%). Fluconazole-resistant and voriconazole non-wild-type isolates were likely to harbour substitution Y132F if posaconazole was wild type; however, if posaconazole was non-wild type, substitution G458S was indicated if isavuconazole MIC was >0.125 mg/L or substitution Y132F if isavuconazole MIC was ≤0.125 mg/L.

Conclusions: We detected a recent clonal spread of fluconazole-resistant C. parapsilosis across some cities in Spain, mostly driven by dominating city-specific genotypes, which involved a large number of isolates harbouring the Y132F ERG11p substitution. Isolates harbouring substitution Y132F can be suspected because they are non-susceptible to voriconazole and rarely posaconazole-resistant.

Keywords: C. parapsilosis; Madrid; Rome; Y132F; fluconazole resistance; genotyping.

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References

REFERENCES

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