Back to Search
Start Over
Molecular characterization and antifungal susceptibility testing of Candida nivariensis from blood samples - an Iranian multicentre study and a review of the literature.
- Source :
-
Journal of medical microbiology [J Med Microbiol] 2019 May; Vol. 68 (5), pp. 770-777. Date of Electronic Publication: 2019 Mar 29. - Publication Year :
- 2019
-
Abstract
- Purpose: Identification of the emerging yeast species Candida nivariensis among presumptively identified Iranian Candida glabrata isolates.<br />Methodology: Clinical C. glabrata species complex isolates from blood (n=71; 33.3 %), urine (n=100; 46.9 %), vaginal swabs (n=20;9.4 %), BAL (n=10; 4.7 %), and sputum (n=12; 5.6 %) from Iran were investigated. Isolates were characterized by CHROMagar, multiplex PCRs, matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS), amplified fragment length polymorphism (AFLP) fingerprinting, internal transcribed spacer (ITS)/large subunit (LSU) rDNA and FKS1/FKS2 sequencing, and the European Committee on Antimicrobial Susceptibility Testing broth microdilution method. A comprehensive literature review was conducted and all the relevant clinical and microbiological data were collected.<br />Results: Four C. nivariensis isolates were recovered from blood samples of three subjects and were all consistently identified by nine-plex PCR, Bruker MALDI-TOF MS, and LSU and ITS rDNA sequencing. AFLP genotyping clustered the isolates into two groups. Sequencing of the FKS1 and FKS2 hotspots showed no accountable amino acid substitutions. All isolates were susceptible to amphotericin B, fluconazole, itraconazole, posaconazole, voriconazole, anidulafungin and micafungin.<br />Conclusion: In total, 4 out of 213 clinical C. glabrata species complex candidemia isolates were C. nivariensis. Improvement of the BioMerieux Vitek MS database is required to accurately identify C. nivariensis and it is advised to alternatively use CHROMagar and/or PCR-based techniques. As other species within the Nakaseomyces clade may cause infection and showed high MIC values for antifungals, inclusion of their spectra into the MALDI-TOF MS database seems relevant. Due to developing resistance to fluconazole and insufficient efficacy of caspofungin, the combination of catheter removal plus treatment with caspofungin, or voriconazole, or micafungin might be effective for patients.
- Subjects :
- Adolescent
Aged
Amphotericin B pharmacology
Amphotericin B therapeutic use
Amplified Fragment Length Polymorphism Analysis
Antifungal Agents therapeutic use
Bronchoalveolar Lavage
Candida isolation & purification
Candidemia diagnosis
Candidemia drug therapy
Candidiasis drug therapy
Caspofungin pharmacology
Caspofungin therapeutic use
DNA, Intergenic
Fatal Outcome
Female
Fluconazole pharmacology
Fluconazole therapeutic use
Genotype
Humans
Iran
Male
Microbial Sensitivity Tests
Middle Aged
Polymerase Chain Reaction
Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
Vagina microbiology
Voriconazole pharmacology
Voriconazole therapeutic use
Antifungal Agents pharmacology
Candida drug effects
Candida genetics
Candidiasis blood
Subjects
Details
- Language :
- English
- ISSN :
- 1473-5644
- Volume :
- 68
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of medical microbiology
- Publication Type :
- Academic Journal
- Accession number :
- 30924763
- Full Text :
- https://doi.org/10.1099/jmm.0.000963