Genotyping and drug resistance profile of Candida spp. in recurrent and one-off vaginitis, and high association of non-albicans species with non-pregnant status

Chong, Pei Pei; Hadi, Siti Rohani Abdul; Lee, Yee Lean; Phan, Chia Wei; Tan, Boon Chong; Ng, Kee Peng; Seow, Heng Fong

doi:10.1016/j.meegid.2007.01.004

Cited by 29 publications

(17 citation statements)

References 21 publications

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“…Genomic DNA was extracted, and random amplification of polymorphic DNA (RAPD) analysis was performed using previously described primers (ERIC2, M13, OPE18, and OPA18) (11)(12)(13)(14). RAPD profiles were compared with each other and against genomic DNA extracted from a control isolate (C. glabrata ATCC 2001) on 1.2% (wt/vol) agarose gels and visualized with UV light following ethidium bromide staining.…”

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confidence: 99%

Rapid Emergence of Echinocandin Resistance in Candida glabrata Resulting in Clinical and Microbiologic Failure

Lewis

Wiederhold

Wickes

et al. 2013

Antimicrob Agents Chemother

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We report a case of Candida glabrata candidemia that developed resistance to micafungin within 8 days of initiation of therapy in a patient without previous echinocandin exposure or other known risk factors for clinical or microbiological failure. Pre-and postresistant isolates were confirmed to be isogenic, and sequencing of hot spots known to confer echinocandin resistance revealed a phenylalanine deletion at codon 659 within FKS2. Echinocandins are now first-line agents for the treatment of invasive candidiasis (1-4). Their fungicidal activity, tolerability, perceived lack of resistance issues, and clinical superiority over fluconazole for candidemia have made them a cornerstone of anti-Candida therapy (5). However, there are increasing reports of Candida spp. becoming resistant to the echinocandins, usually in immunocompromised patients receiving prolonged therapy (6, 7). In addition, there is debate over the recent changes to the CLSI echinocandin breakpoints for Candida spp., which significantly lowered the threshold for resistance for many species, including Candida glabrata (8). We describe a case of rapid emergence of echinocandin resistance and clinical failure in a patient with C. glabrata fungemia who lacked the usual risk factors for echinocandin resistance (6, 9, 10).Case. A female patient in her mid-50s presented to the emergency department with acute pyelonephritis and persistent vomiting for the past 6 days. Her medical history was significant for a cerebrovascular accident 5 years previously, poorly controlled type 2 diabetes, and hypertension. Blood and urine cultures obtained in the emergency department grew Escherichia coli that was resistant to ciprofloxacin and trimethoprim-sulfamethoxazole. In the emergency department, her blood glucose was Ͼ500 mg/dl, she was treated for an anion gap metabolic acidosis, and she received vancomycin and piperacillin-tazobactam. She improved initially but was transferred to the medical intensive care unit (MICU) due to hypotension and respiratory failure requiring intubation. On hospital day (HD) 3, antibiotics were de-escalated to ceftriaxone when culture and susceptibility results returned. The patient developed acute kidney injury that required dialysis through a left femoral vein catheter but otherwise experienced a relatively uncomplicated ICU stay. On HD 11, she was transferred to the medical service, but on HD 13 she developed fever to 102.9°F and was restarted on vancomycin and piperacillin-tazobactam. No bacterial pathogens were isolated for the remainder of her hospital stay. The next day, fluconazole at 200 mg daily was initiated. On HD 15, blood cultures from HD 13 were positive for Candida sp., which was later identified as C. glabrata using the YST card with Vitek 2 and was susceptible-dose dependent (SDD) to fluconazole with an MIC of 16 g/ml and susceptible to micafungin, anidulafungin, and caspofungin with MICs of 0.015, 0.06, and 0.06 g/ml, respectively (Trek Sensititre YeastOne broth microdilution panel). On HD 15, fluconazole was discont...

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confidence: 99%

Rapid Emergence of Echinocandin Resistance in Candida glabrata Resulting in Clinical and Microbiologic Failure

Lewis

Wiederhold

Wickes

et al. 2013

Antimicrob Agents Chemother

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“…Indeed, susceptibility testing of VVC-causing isolates has been performed in different countries and regions of the world (1, 2, 4, 5, 6, 13-15, 17, 18, 20, 24). Although relatively high frequencies of fluconazole-and/or itraconazole-resistant C. albicans isolates causing VVC have been observed in a few reports (13,20,24), most studies failed to identify any clear correlation between azole susceptibility and VVC association among C. albicans isolates (1,2,4,5,6,14,15,17,18).…”

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Correlation between Azole Susceptibilities, Genotypes, and ERG11 Mutations in Candida albicans Isolates Associated with Vulvovaginal Candidiasis in China

Wan

et al. 2010

Antimicrob Agents Chemother

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The relationship between susceptibilities to fluconazole and itraconazole and microsatellite CAI genotypes were examined from a total of 154 Candida albicans isolates (97 isolates causing vulvovaginitis in Chinese women and 6 vaginal isolates and 51 oral cavity isolates from asymptomatic carriers). The two dominant genotypes, CAI 30-45 (45 isolates) and CAI 32-46 (33 isolates), associated with vulvovaginitis showed significantly different azole susceptibility patterns with strong statistical support. CAI 32-46 isolates were usually less susceptible to both fluconazole and itraconazole than CAI 30-45 isolates and than the oral isolates with other diversified CAI genotypes. Remarkably different mutation patterns in the azole target gene ERG11 were correspondingly observed among C. albicans isolates representing different genotypes and sources. Isolates with the same or similar CAI genotypes usually possessed identical or phylogenetically closely related ERG11 sequences. Loss of heterozygosity in ERG11 was observed in all the CAI 32-46 isolates but not in the CAI 30-45 isolates and most of the oral isolates sequenced. Compared with the ERG11 sequence of strain SC5314 (X13296), two homozygous missense mutations (G487T and T916C) leading to two amino acid changes (A114S and Y257H) in Erg11p were found in CAI 32-46 isolates. The correlation between azole susceptibility and C. albicans genotype may be of potential therapeutic significance.

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“…Molecular marker systems based on ERIC elements have become a powerful alternative tool for microbiological diagnostics owing to their simplicity, speed, reproducibility, and accuracy (He et al, 2012). Thus, ERIC-based systems have been widely used in studies on genetic variability and genotyping in bacteria and fungi, as reported for Acetobacter pasteurianus (Wu et al, 2010), Fusarium solani (Godoy et al, 2004), Candida spp (Chong et al, 2007), and Aureobasidium pullulans (Loncaric et al, 2009). …”

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confidence: 99%

Genetic diversity of Mycosphaerella fijiensis in Brazil analyzed using an ERIC-PCR marker

Silva¹,

Paixão²,

Queiroz³

et al. 2014

Genet. Mol. Res.

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ABSTRACT. The Enterobacterial repetitive intergenic consensus (ERIC)marker was used to analyze the genetic variability of Mycosphaerella fijiensis, the causative agent of Black Sigatoka disease in banana plants. A total of 123 isolates were used, which were divided into populations based on their original hosts and collection sites in Brazil. A total of 9 loci were amplified, 77.8% of which were found to be polymorphic. The genetic diversity found in the population was 0.20. Analysis of molecular variance (AMOVA) demonstrated that the highest level of genetic variation is within populations. Cluster analysis revealed three main groups in Brazil, with no correlation between geographic and genetic distance.

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Genotyping and drug resistance profile of Candida spp. in recurrent and one-off vaginitis, and high association of non-albicans species with non-pregnant status

Cited by 29 publications

References 21 publications

Rapid Emergence of Echinocandin Resistance in Candida glabrata Resulting in Clinical and Microbiologic Failure

Rapid Emergence of Echinocandin Resistance in Candida glabrata Resulting in Clinical and Microbiologic Failure

Correlation between Azole Susceptibilities, Genotypes, and ERG11 Mutations in Candida albicans Isolates Associated with Vulvovaginal Candidiasis in China

Genetic diversity of Mycosphaerella fijiensis in Brazil analyzed using an ERIC-PCR marker

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