Emerging Infectious Diseases (Mar 2023)

Clonal Dissemination of Antifungal-Resistant Candida haemulonii, China

  • Xinfei Chen,
  • Xinmiao Jia,
  • Jian Bing,
  • Han Zhang,
  • Nan Hong,
  • Yun Liu,
  • Haiyang Xi,
  • Weiping Wang,
  • Zhiyong Liu,
  • Qiangqiang Zhang,
  • Li Li,
  • Mei Kang,
  • Yuling Xiao,
  • Bin Yang,
  • Yulan Lin,
  • Hui Xu,
  • Xin Fan,
  • Jingjing Huang,
  • Jie Gong,
  • Juan Xu,
  • Xiuli Xie,
  • Wenhang Yang,
  • Ge Zhang,
  • Jingjia Zhang,
  • Wei Kang,
  • He Wang,
  • Xin Hou,
  • Meng Xiao,
  • Yingchun Xu

DOI
https://doi.org/10.3201/eid2903.221082
Journal volume & issue
Vol. 29, no. 3
pp. 576 – 584

Abstract

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Candida haemulonii, a relative of C. auris, frequently shows antifungal resistance and is transmissible. However, molecular tools for genotyping and investigating outbreaks are not yet established. We performed genome-based population analysis on 94 C. haemulonii strains, including 58 isolates from China and 36 other published strains. Phylogenetic analysis revealed that C. haemulonii can be divided into 4 clades. Clade 1 comprised strains from China and other global strains; clades 2–4 contained only isolates from China, were more recently evolved, and showed higher antifungal resistance. Four regional epidemic clusters (A, B, C, and D) were identified in China, each comprising ≥5 cases (largest intracluster pairwise single-nucleotide polymorphism differences <50 bp). Cluster A was identified in 2 hospitals located in the same city, suggesting potential intracity transmissions. Cluster D was resistant to 3 classes of antifungals. The emergence of more resistant phylogenetic clades and regional dissemination of antifungal-resistant C. haemulonii warrants further monitoring.

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