Clonality of Fluconazole-Nonsusceptible Candida tropicalis in Bloodstream Infections, Taiwan 2011-2017
Clonality of Fluconazole-Nonsusceptible Candida tropicalis in Bloodstream Infections, Taiwan 2011-2017
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DOI：
10.3201/eid2509.190520
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发表时间：
2019-09-01
影响因子：
11.8
通讯作者：
Chang, Shan-Chwen
中科院分区：
文献类型：
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作者：
Chen, Pao-Yu;Chuang, Yu-Chung;Chang, Shan-Chwen
热带假丝酵母菌是引起非念珠菌感染的主要原因。热带亚洲和拉丁美洲的白念珠菌感染。我们评估了344名最初出现热带念珠菌血症的患者的分离株。发现58例(16.9%)患者感染氟康唑不敏感(FNS)热带葡萄球菌，对伊曲康唑、伏立康唑和泊沙康唑交叉耐药，55.2%(32/58)的患者未使用唑类药物。多位点序列分型分析表明，FNS分离株在遗传上有密切的亲缘关系，但我们没有看到时间或地点的聚集。在二倍体序列类型中，我们注意到了台湾水果和北京医院报道的DST225，中国，以及上海医院报道的DST376和DST505-7，中国。我们的发现表明热带口蹄疫的跨境扩展，并强调了积极监测临床分离株的重要性，以发现这种病原体的传播并探索社区的潜在来源。
Candida tropicalis is the leading cause of non-C. albicans candidemia in tropical Asia and Latin America. We evaluated isolates from 344 patients with an initial episode of C. tropicalis candidemia. We found that 58 (16.9%) patients were infected by fluconazole-nonsusceptible (FNS) C. tropicalis with cross resistance to itraconazole, voriconazole, and posaconazole; 55.2% (32/58) of patients were azole-naive. Multilocus sequence typing analysis revealed FNS isolates were genetically closely related, but we did not see time- or place-clustering. Among the diploid sequence types (DSTs), we noted DST225, which has been reported from fruit in Taiwan and hospitals in Beijing, China, as well as DST376 and DST505-7, which also were reported from hospitals in Shanghai, China. Our findings suggest cross-boundary expansion of FNS C. tropicalis and highlight the importance of active surveillance of clinical isolates to detect dissemination of this pathogen and explore potential sources in the community.