First Report of Candidemia Clonal Outbreak Caused by Emerging Fluconazole-Resistant Candida parapsilosis Isolates Harboring Y132F and/or Y132F+K143R in Turkey.

Antimicrobial Agents and Chemotherapy
Amir ArastehfarTeun Boekhout

Abstract

Clonal outbreaks of fluconazole-resistant (FLZR) Candida parapsilosis isolates have been reported in several countries. Despite its being the second leading cause of candidemia, the azole resistance mechanisms and the clonal expansion of FLZR C. parapsilosis blood isolates have not been reported in Turkey. In this study, we consecutively collected C. parapsilosis blood isolates (n = 225) from the fifth largest hospital in Turkey (2007 to 2019), assessed their azole susceptibility pattern using CLSI M27-A3/S4, and sequenced ERG11 for all and MRR1, TAC1, and UPC2 for a selected number of C. parapsilosis isolates. The typing resolution of two widely used techniques, amplified fragment length polymorphism typing (AFLP) and microsatellite typing (MST), and the biofilm production of FLZR isolates with and without Y132F were compared. Approximately 27% of isolates were FLZR (60/225), among which 90% (54/60) harbored known mutations in Erg11, including Y132F (24/60) and Y132F+K143R (19/60). Several mutations specific to FLZR isolates were found in MRR1, TAC1, and UPC2 AFLP grouped isolates into two clusters, while MST revealed several clusters. The majority of Y132F/Y132F+K143R isolates grouped in clonal clusters, which significantly e...Continue Reading

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Citations

Aug 23, 2020·Journal of Fungi·Amir ArastehfarDavid S Perlin
Jan 13, 2021·Journal of Fungi·Emilia Gómez-MoleroOliver Bader
May 11, 2021·Frontiers in Cellular and Infection Microbiology·Amir ArastehfarCornelia Lass-Flörl
May 22, 2021·Infectious Disease Clinics of North America·Ronen Ben-Ami, Dimitrios P Kontoyiannis
Jun 12, 2021·Critical Reviews in Microbiology·Amir ArastehfarArnaldo Lopes Colombo

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