Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañóngrid.410526.4, Madrid, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain.
Antimicrob Agents Chemother. 2022 Aug 16;66(8):e0071022. doi: 10.1128/aac.00710-22. Epub 2022 Jul 19.
We have been monitoring the antifungal resistance in Candida parapsilosis isolates collected from inpatients at Madrid metropolitan area hospitals for the last 3 years. The study aimed to elucidate the presence of fluconazole-resistant C. parapsilosis genotypes in Madrid. From January 2019 to December 2021, a total of 354 C. parapsilosis isolates ( = 346 patients) from blood (76.6%) or intraabdominal samples were collected and genotyped using species-specific microsatellite markers. Antifungal susceptibilities to amphotericin B, the triazoles, micafungin, anidulafungin, and ibrexafungerp were performed according to EUCAST E.Def 7.3.2; the gene was sequenced in fluconazole-resistant isolates. A total of 13.6% ( = 48/354) isolates (one per patient) were found to be resistant to fluconazole and non-wild-type to voriconazole but fully susceptible to ibrexafungerp. Resistant isolates were mostly sourced from blood ( = 45/48, 93.8%) and were detected in five hospitals. Two hospitals accounted for a high proportion of resistant isolates ( = 41/48). Resistant isolates harbored either the Y132F ERG11p amino acid substitution ( = 43) or the G458S substitution ( = 5). Isolates harboring the Y132F substitution clustered into a clonal complex involving three genotypes (one genotype accounted for = 39/43 isolates) that were found in four hospitals. Isolates harboring the G458S substitution clustered into another genotype found in a fifth hospital. C. parapsilosis genotypes demonstrating resistance to fluconazole have been spreading across hospitals in Madrid, Spain. Over the last 3 years, the frequency of isolation of such isolates and the number of hospitals affected is on the rise.
我们一直在监测过去 3 年来马德里大都市区医院住院患者分离的近平滑念珠菌的抗真菌耐药性。该研究旨在阐明马德里地区耐氟康唑的近平滑念珠菌基因型的存在情况。从 2019 年 1 月至 2021 年 12 月，共收集了来自血液（76.6%）或腹腔样本的 354 株近平滑念珠菌（ = 346 例患者），并使用种特异性微卫星标记物进行了基因分型。根据 EUCAST E.Def 7.3.2 进行了两性霉素 B、三唑类药物、米卡芬净、阿尼芬净和艾沙康唑的药敏试验；对氟康唑耐药株进行了 基因测序。共发现 13.6%（ = 48/354）的分离株（每个患者 1 株）对氟康唑耐药且伏立康唑非野生型，但对艾沙康唑完全敏感。耐药分离株主要来源于血液（ = 45/48，93.8%），并在五家医院中检测到。两家医院耐药分离株比例较高（ = 41/48）。耐药分离株携带 Y132F ERG11p 氨基酸取代（ = 43）或 G458S 取代（ = 5）。携带 Y132F 取代的分离株聚类为涉及三种基因型的克隆复合体（一种基因型占 = 43/43 株），在四家医院中发现。携带 G458S 取代的分离株聚类为另一种基因型，在第五家医院中发现。对氟康唑耐药的近平滑念珠菌基因型已在西班牙马德里的医院中传播。在过去的 3 年中，此类分离株的分离频率和受影响的医院数量呈上升趋势。
