Recent Increase in the Prevalence of Fluconazole-Non-susceptible Candida tropicalis Blood Isolates in Turkey: Clinical Implication of Azole-Non-susceptible and Fluconazole Tolerant Phenotypes and Genotyping.
Recent Increase in the Prevalence of Fluconazole-Non-susceptible Candida tropicalis Blood Isolates in Turkey: Clinical Implication of Azole-Non-susceptible and Fluconazole Tolerant Phenotypes and Genotyping.
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最近土耳其氟康唑不敏感热带念珠菌血液分离株患病率增加：唑不敏感和氟康唑耐受表型和基因分型的临床意义
DOI：
10.3389/fmicb.2020.587278
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发表时间：
2020
影响因子：
5.2
通讯作者：
Lass-Flörl C
中科院分区：
文献类型：
--
作者：
Arastehfar A;Hilmioğlu-Polat S;Daneshnia F;Hafez A;Salehi M;Polat F;Yaşar M;Arslan N;Hoşbul T;Ünal N;Metin DY;Gürcan Ş;Birinci A;Koç AN;Pan W;Ilkit M;Perlin DS;Lass-Flörl C
热带念珠菌是土耳其念珠菌血症的第四大原因。虽然C.从1997年到2017年，热带假丝酵母分离株的特征是对抗真菌药物完全敏感，唑类非敏感（ANS）C的全球流行率增加。热带念珠菌的耐药性以及高氟康唑耐受性（HFT）与氟康唑治疗失败（FTF）之间的相关性促使我们重新评估念珠菌的唑类药物敏感性。土耳其的热带雨林在本研究中，161 C.通过ITS rDNA测序鉴定来自7个临床中心的热带假单胞菌血液分离株，通过多位点微卫星分型进行基因分型，并检测对5种唑类、2种棘白菌素和阿替霉素B（AMB）的敏感性;通过ERG 11和FKS 1基因测序评估抗真菌药耐药机制。结果表明，C.热带假单胞菌菌株，其中属于125基因型分为11个集群，是完全敏感棘白菌素和AMB的，但是，18.6%的人有ANS表型，但只有两个进行ANS赋予突变（Y132 F）。在52个分离物中记录到HFT，其中10个也是ANS。大部分感染ANS和HFT分离株的患者（分别为89%和40.7%）显示FTF。感染唑敏感或ANS分离株的患者死亡率没有差异，然而，感染HFT分离株的患者死亡率显著降低（P = 0.007）。基因型簇之间的死亡率（P = 0.02）、ANS（P = 0.012）和HFT（P = 0.007）存在显著差异。C.在土耳其，与ANS和HFT的热带血分离株和显着的FTF率应该是一个公共卫生问题。
Candida tropicalis is the fourth leading cause of candidemia in Turkey. Although C. tropicalis isolates from 1997 to 2017 were characterized as fully susceptible to antifungals, the increasing global prevalence of azole-non-susceptible (ANS) C. tropicalis and the association between high fluconazole tolerance (HFT) and fluconazole therapeutic failure (FTF) prompted us to re-evaluate azole susceptibility of C. tropicalis in Turkey. In this study, 161 C. tropicalis blood isolates from seven clinical centers were identified by ITS rDNA sequencing, genotyped by multilocus microsatellite typing, and tested for susceptibility to five azoles, two echinocandins, and amphotericin B (AMB); antifungal resistance mechanisms were assessed by sequencing of ERG11 and FKS1 genes. The results indicated that C. tropicalis isolates, which belonged to 125 genotypes grouped into 11 clusters, were fully susceptible to echinocandins and AMB; however, 18.6% of them had the ANS phenotype but only two carried the ANS-conferring mutation (Y132F). HFT was recorded in 52 isolates, 10 of which were also ANS. Large proportions of patients infected with ANS and HFT isolates (89 and 40.7%, respectively) showed FTF. Patients infected with azole-susceptible or ANS isolates did not differ in mortality, which, however, was significantly lower for those infected with HFT isolates (P = 0.007). There were significant differences in mortality (P = 0.02), ANS (P = 0.012), and HFT (P = 0.007) among genotype clusters. The alarming increase in the prevalence of C. tropicalis blood isolates with ANS and HFT in Turkey and the notable FTF rate should be a matter of public health concern.
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影响因子：
5.2
作者：
Byun SA;Won EJ;Kim MN;Lee WG;Lee K;Lee HS;Uh Y;Healey KR;Perlin DS;Choi MJ;Kim SH;Shin JH
通讯作者：
Shin JH
影响因子：
38.9
作者：
Chakrabarti, Arunaloke;Sood, Prashant;Mendiratta, Deepak
通讯作者：
Mendiratta, Deepak
影响因子：
1.9
作者：
Carvalho, Vagner Oliveira;Okay, Thelma S.;del Negro, Gilda M. B.
通讯作者：
del Negro, Gilda M. B.
影响因子：
11.8
作者：
Chen, Pao-Yu;Chuang, Yu-Chung;Chang, Shan-Chwen
通讯作者：
Chang, Shan-Chwen
2015 年至 2018 年多中心研究中从血液样本中回收的伊朗光滑念珠菌分离株的低水平抗真菌耐药性以及 PDR1 基因分型和测序的潜在预后价值
影响因子：
4.9
作者：
Arastehfar, Amir;Daneshnia, Farnaz;Boekhout, Teun
通讯作者：
Boekhout, Teun