Journal of Fungi (Nov 2022)

<i>Candida</i> Genotyping of Blood Culture Isolates from Patients Admitted to 16 Hospitals in Madrid: Genotype Spreading during the COVID-19 Pandemic Driven by Fluconazole-Resistant <i>C. parapsilosis</i>

  • Judith Díaz-García,
  • Ana Gómez,
  • Marina Machado,
  • Luis Alcalá,
  • Elena Reigadas,
  • Carlos Sánchez-Carrillo,
  • Ana Pérez-Ayala,
  • Elia Gómez-García de la Pedrosa,
  • Fernando González-Romo,
  • María Soledad Cuétara,
  • Coral García-Esteban,
  • Inmaculada Quiles-Melero,
  • Nelly Daniela Zurita,
  • María Muñoz Algarra,
  • María Teresa Durán-Valle,
  • Aída Sánchez-García,
  • Patricia Muñoz,
  • Pilar Escribano,
  • Jesús Guinea,
  • on behalf of the CANDIMAD Study Group

DOI
https://doi.org/10.3390/jof8111228
Journal volume & issue
Vol. 8, no. 11
p. 1228

Abstract

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Background: Candidaemia and invasive candidiasis are typically hospital-acquired. Genotyping isolates from patients admitted to different hospitals may be helpful in tracking clones spreading across hospitals, especially those showing antifungal resistance. Methods: We characterized Candida clusters by studying Candida isolates (C. albicans, n = 1041; C. parapsilosis, n = 354, and C. tropicalis, n = 125) from blood cultures (53.8%) and intra-abdominal samples (46.2%) collected as part of the CANDIMAD (Candida in Madrid) study in Madrid (2019–2021). Species-specific microsatellite markers were used to define the genotypes of Candida spp. found in a single patient (singleton) or several patients (cluster) from a single hospital (intra-hospital cluster) or different hospitals (widespread cluster). Results: We found 83 clusters, of which 20 were intra-hospital, 49 were widespread, and 14 were intra-hospital and widespread. Some intra-hospital clusters were first detected before the onset of the COVID-19 pandemic, but the number of clusters increased during the pandemic, especially for C. parapsilosis. The proportion of widespread clusters was significantly higher for genotypes found in both compartments than those exclusively found in either the blood cultures or intra-abdominal samples. Most C. albicans- and C. tropicalis-resistant genotypes were singleton and presented exclusively in either blood cultures or intra-abdominal samples. Fluconazole-resistant C. parapsilosis isolates belonged to intra-hospital clusters harboring either the Y132F or G458S ERG11p substitutions; the dominant genotype was also widespread. Conclusions: the number of clusters—and patients involved—increased during the COVID-19 pandemic mainly due to the emergence of fluconazole-resistant C. parapsilosis genotypes.

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