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Francisco EC, Ribeiro FDC, Almeida Junior JN, Pedoni DB, da Matta DA, Dolande M, Melo ASDA, Lima RF, Aquino VR, Corzo-León DE, Zurita J, Cortes JA, Nucci M, Colombo AL. Emergence of cryptic species and clades of Meyerozyma guilliermondii species complex exhibiting limited in vitro susceptibility to antifungals in patients with candidemia. Microbiol Spectr 2023; 11:e0511522. [PMID: 37698428 PMCID: PMC10580822 DOI: 10.1128/spectrum.05115-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 07/11/2023] [Indexed: 09/13/2023] Open
Abstract
Members of the Meyerozyma guilliermondii species complex are able to cause superficial and life-threatening systemic infections with low susceptibility to azoles and echinocandins. We tested 130 bloodstream M. guilliermondii complex isolates collected from eight Latin American medical centers over 18 years (period 1 = 2000-2008 and period 2 = 2009-2018) to investigate trends in species distribution and antifungal resistance. The isolates were identified by rDNA ITS region sequencing, and antifungal susceptibility tests were performed against fluconazole, voriconazole, anidulafungin, and amphotericin B using the CLSI microbroth method. M. guilliermondii sensu stricto (s.s.; n = 116) was the most prevalent species, followed by Meyerozyma caribbica (n = 12) and Meyerozyma carpophila (n = 2). Based on rDNA ITS identification, three clades within M. guilliermondii sensu stricto were characterized (clade 1 n = 94; clade 2 n = 19; and clade 3 n = 3). In the second period of study, we found a substantial increment in the isolation of M. caribbica (3.4% versus 13.8%; P = 0.06) and clade 2 M. guilliermondii s.s. exhibiting lower susceptibility to one or more triazoles. IMPORTANCE Yeast-invasive infections play a relevant role in human health, and there is a concern with the emergence of non-Candida pathogens causing disease worldwide. There is a lack of studies addressing the prevalence and antifungal susceptibility of different species within the M. guilliermondii complex that cause invasive infections. We evaluated 130 episodes of M. guilliermondii species complex candidemia documented in eight medical centers over 18 years. We detected the emergence of less common species within the Meyerozyma complex causing candidemia and described a new clade of M. guilliermondii with limited susceptibility to triazoles. These results support the relevance of continued global surveillance efforts to early detect, characterize, and report emergent fungal pathogens exhibiting limited susceptibility to antifungals.
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Affiliation(s)
- Elaine Cristina Francisco
- Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Felipe de Camargo Ribeiro
- Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - João Nobrega Almeida Junior
- Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Diego Betto Pedoni
- Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Daniel Archimedes da Matta
- Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Maribel Dolande
- Department of Mycology, Instituto Nacional de Higiene Rafael Rangel, Caracas, Venezuela
| | - Analy Salles de Azevedo Melo
- Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ricardo Ferreira Lima
- Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Dora E Corzo-León
- MRC Centre for Medical Mycology, University of Exeter, Exeter, United Kingdom
| | - Jeannete Zurita
- Unidad de Investigaciones en Biomedicina, Zurita & Zurita Laboratorios, Quito, Ecuador
- Facultad de Medicina, Pontificia Universidad Catolica del Ecuador, Quito, Ecuador
| | - Jorge Alberto Cortes
- Facultad de Medicina, Universidad Nacional de Colombia, Sede Bogotá, Bogotá, Colombia
| | - Marcio Nucci
- Departamento de Clínica Médica, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Arnaldo Lopes Colombo
- Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo, São Paulo, Brazil
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Gade L, Muñoz JF, Sheth M, Wagner D, Berkow EL, Forsberg K, Jackson BR, Ramos-Castro R, Escandón P, Dolande M, Ben-Ami R, Espinosa-Bode A, Caceres DH, Lockhart SR, Cuomo CA, Litvintseva AP. Understanding the Emergence of Multidrug-Resistant Candida: Using Whole-Genome Sequencing to Describe the Population Structure of Candida haemulonii Species Complex. Front Genet 2020; 11:554. [PMID: 32587603 PMCID: PMC7298116 DOI: 10.3389/fgene.2020.00554] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/07/2020] [Indexed: 11/16/2022] Open
Abstract
The recent emergence of a multidrug-resistant yeast, Candida auris, has drawn attention to the closely related species from the Candida haemulonii complex that include C. haemulonii, Candida duobushaemulonii, Candida pseudohaemulonii, and the recently identified Candida vulturna. Here, we used antifungal susceptibility testing and whole-genome sequencing (WGS) to investigate drug resistance and genetic diversity among isolates of C. haemulonii complex from different geographic areas in order to assess population structure and the extent of clonality among strains. Although most isolates of all four species were genetically distinct, we detected evidence of the in-hospital transmission of C. haemulonii and C. duobushaemulonii in one hospital in Panama, indicating that these species are also capable of causing outbreaks in healthcare settings. We also detected evidence of the rising azole resistance among isolates of C. haemulonii and C. duobushaemulonii in Colombia, Panama, and Venezuela linked to substitutions in ERG11 gene as well as amplification of this gene in C. haemulonii in isolates in Colombia suggesting the presence of evolutionary pressure for developing azole resistance in this region. Our results demonstrate that these species need to be monitored as possible causes of outbreaks of invasive infection.
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Affiliation(s)
- Lalitha Gade
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jose F Muñoz
- Infectious Disease and Microbiome Program, Broad Institute, Cambridge, MA, United States
| | - Mili Sheth
- Biotechnology Core Facility Branch, DSR/NCEZID - Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Darlene Wagner
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States.,IHRC, Inc., Atlanta, GA, United States
| | - Elizabeth L Berkow
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Kaitlin Forsberg
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Brendan R Jackson
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Ruben Ramos-Castro
- Department of Clinical and Molecular Microbiology, Instituto Conmemorativo Gorgas de Estudios de La Salud, Panama City, Panama
| | - Patricia Escandón
- Grupo de Microbiologia, Instituto Nacional de Salud, Bogotá, Colombia
| | - Maribel Dolande
- Departamento de Micología, Instituto Nacional de Higiene Rafael Rangel, Caracas, Venezuela
| | - Ronen Ben-Ami
- Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Andrés Espinosa-Bode
- DGHP (Division of Global Health Protection), Central America Region Office, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Diego H Caceres
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States.,Center of Expertise in Mycology Radboudumc/CWZ, Nijmegen, Netherlands
| | - Shawn R Lockhart
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Christina A Cuomo
- Infectious Disease and Microbiome Program, Broad Institute, Cambridge, MA, United States
| | - Anastasia P Litvintseva
- Mycotic Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, United States
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Ferrara G, Panizo MM, Urdaneta E, Alarcón V, García N, Moreno X, Capote AM, Reviakina V, Dolande M. Characterization by PCR-RFLP of the Cryptococcus neoformans and Cryptococcus gattii species complex in Venezuela. ACTA ACUST UNITED AC 2018. [DOI: 10.22209/ic.v59n1a03] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Dolande M, García N, Capote AM, Panizo MM, Ferrara G, Alarcón V. Candida auris: Antifungal Multi-Resistant Emerging Yeast. Curr Fungal Infect Rep 2017. [DOI: 10.1007/s12281-017-0299-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Moreno X, Reviakina V, Panizo MM, Ferrara G, García N, Alarcón V, Garcés MF, Dolande M. [Molecular identification and in vitro antifungal susceptibility of blood isolates of the Candida parapsilosis species complex in Venezuela]. Rev Iberoam Micol 2017; 34:165-170. [PMID: 28457646 DOI: 10.1016/j.riam.2016.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Revised: 10/30/2016] [Accepted: 11/17/2016] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Candida parapsilosis is a species complex consisting of Candida parapsilosis sensu stricto, Candida orthopsilosis, and Candida metapsilosis. Studies worldwide have described its epidemiology and susceptibility to antifungal agents. AIMS The aims of this study were to carry out the molecular identification of blood isolates belonging to the Candida parapsilosis species complex, and to determine their in vitro susceptibility to antifungals of systemic use. METHODS A study of 86 strains of C. parapsilosis species complex collected in 2008-2011 and obtained from the Candidaemia Surveillance Network of Mycology Department of the Rafael Rangel National Institute of Hygiene, was made. Secondary alcohol-dehydrogenase gene amplification was performed using polymerase chain reaction, and the products were analysed by restriction fragments length polymorphisms using the enzyme BanI. Susceptibility tests were performed using Etest®, following the manufacturer's instructions with modifications. RESULTS Of the 86 isolates studied, 81 (94.2%) were C. parapsilosis sensu stricto, 4 (4.6%) C. orthopsilosis, and one (1.2%) C. metapsilosis. C. parapsilosis isolates were susceptible to amphotericin B and caspofungin, showing low rates of resistance to fluconazole and voriconazole. C. orthopsilosis and C. metapsilosis were susceptible to all the antifungals tested. CONCLUSIONS The results obtained in Venezuela provide for the first time important information about the distribution of C. parapsilosis species complex in cases of candidaemia, and support the need for continuing surveillance programs, including molecular discrimination of species and antifungal susceptibility tests, which may guide specific therapy.
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Affiliation(s)
- Xiomara Moreno
- Departamento de Microbiología, Instituto Médico La Floresta, Caracas, Venezuela.
| | - Vera Reviakina
- Departamento de Micología, Instituto Nacional de Higiene Rafael Rangel, Caracas, Venezuela
| | - María M Panizo
- Departamento de Micología, Instituto Nacional de Higiene Rafael Rangel, Caracas, Venezuela
| | - Giusseppe Ferrara
- Departamento de Micología, Instituto Nacional de Higiene Rafael Rangel, Caracas, Venezuela
| | - Nataly García
- Departamento de Micología, Instituto Nacional de Higiene Rafael Rangel, Caracas, Venezuela
| | - Víctor Alarcón
- Departamento de Micología, Instituto Nacional de Higiene Rafael Rangel, Caracas, Venezuela
| | - María F Garcés
- Laboratorio de Investigaciones Básicas y Aplicadas, Escuela de Bioanálisis, Universidad Central de Venezuela, Caracas, Venezuela
| | - Maribel Dolande
- Departamento de Micología, Instituto Nacional de Higiene Rafael Rangel, Caracas, Venezuela
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Capote AM, Ferrara G, Panizo MM, García N, Alarcón V, Reviakina V, Dolande M. [Superficial mycoses: casuistry of the Mycology Department of the Instituto Nacional de Higiene "Rafael Rangel", Caracas, Venezuela (2001-2014)]. Invest Clin 2016; 57:47-58. [PMID: 27382801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The superficial mycoses are very common infectious diseases and therefore are a frequent reason for medical consultation. The aim of this study was to determine the diagnostic frequency of superficial mycoses in the Mycology Department of the Instituto Nacional de Higiene "Rafael Rangel" during 14 years (2001-2014). A retrospective cross-sectional study was performed to review the mycological records of patients with presumptive diagnosis of superficial mycosis. Nails, hairs and epidermal scales were the processed samples. The identification of fungi was performed by macro and microscopic observation of colonies and biochemical and physiological tests, as required of the isolated agent. For the investigation of Malassezia spp. only direct examination was performed. Of the 3 228 samples processed, 1 098 (34%) were positive and their distribution according to the etiological agent was: dermatophytes 79.5%; 10.9% yeasts; non-dermatophytes fungi 5.1% and 4.5% Malassezia spp. The most frequently isolated dermatophyte was Trichophyton rubrum Complex (70.1%), followed by T mentagrophytes complex (15.1%), Microsporum canis (9.4%) and Epidermophyton floccosum (4%). The most frequent ringworms Were: Tinea unguium (66.8%), followed by Tineapedis (16.4%) and Tinea capitis (8.1%). Candida parapsilosis complex (37.5%) was the most frequently isolated yeast and Fusarium spp. (53.6%) was the most isolated among non-dermatophyte fungi, followed by Aspergillus spp. (19.6%) and Acremonium spp. (10.7%). The identification of the etiological agent is essential to guide appropriate treatment. This study constitutes an important contribution to the knowledge of the epidemiology of superficial mycoses in our country.
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Pereira Silveira C, Torres-Rodríguez JM, Alvarado-Ramírez E, Murciano-Gonzalo F, Dolande M, Panizo M, Reviakina V. MICs and minimum fungicidal concentrations of amphotericin B, itraconazole, posaconazole and terbinafine in Sporothrix schenckii. J Med Microbiol 2009; 58:1607-1610. [PMID: 19679687 DOI: 10.1099/jmm.0.007609-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The in vitro susceptibility of 62 isolates of Sporothrix schenckii in its mycelial form, from Latin-American countries (Peru, Venezuela, Brazil and Uruguay) and Spain, to amphotericin B (AB), itraconazole (IZ), posaconazole (PZ) and terbinafine (TB) was determined by measuring the MICs and minimum fungicidal concentrations (MFCs) using a standardized Clinical and Laboratory Standards Institute method. In general, TB was the most active drug, with the lowest geometric mean (GM) MIC and MFC values amongst isolates from the five countries tested. IZ and PZ showed almost the same activity against all strains tested, except for isolates from Uruguay where IZ gave the highest GM MIC (10.68 mg l(-1)). AB showed the widest MIC range (0.03-16.0 mg l(-1)); however, this drug was less active against 79 % of isolates (MICs above 1 mg l(-1)). MFCs were 5 to 20 times higher than the MICs, but the lowest GM MFC and range values were found for TB. IZ and PZ gave the highest GM MFC. MFC may be a better predictor of therapeutic response than MIC, especially in immunosuppressed patients, making the use of IZ and PZ an inappropriate treatment. There were some differences in susceptibility according to the geographical source of the isolates, with the MIC being lower for TB in Venezuelan strains (P=0.066) and the MFC higher for PZ in Peruvian strains (P=0.02). Thus, geographical origin may be important for appropriate treatment, and may relate to the identification of species of the S. schenckii complex.
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Affiliation(s)
- Carolina Pereira Silveira
- Centro de Biotecnologia, Universidade Federal do Rio Grande do Sul, PO Box 15005, 91501-970 Porto Alegre, RS, Brazil
| | - Josep M Torres-Rodríguez
- UDIMAS, Autonomous University of Barcelona, Barcelona, Spain.,Unitat de Recerca en Malalties Infeccioses i Micologia, Institut Municipal d'Investigació Médica, Barcelona, Spain
| | - Eidi Alvarado-Ramírez
- UDIMAS, Autonomous University of Barcelona, Barcelona, Spain.,Unitat de Recerca en Malalties Infeccioses i Micologia, Institut Municipal d'Investigació Médica, Barcelona, Spain
| | - Francisca Murciano-Gonzalo
- Unitat de Recerca en Malalties Infeccioses i Micologia, Institut Municipal d'Investigació Médica, Barcelona, Spain
| | - Maribel Dolande
- Mycology Department, Natonal Institute of Hygiene Rafael Rangel, Caracas, Bolivarian Republic of Venezuela
| | - Mercedes Panizo
- Mycology Department, Natonal Institute of Hygiene Rafael Rangel, Caracas, Bolivarian Republic of Venezuela
| | - Vera Reviakina
- Mycology Department, Natonal Institute of Hygiene Rafael Rangel, Caracas, Bolivarian Republic of Venezuela
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Panizo MM, Reviákina V, Dolande M, Selgrad S. Candidaspp.in vitrosusceptibility profile to four antifungal agents. Resistance surveillance study in Venezuelan strains. Med Mycol 2009; 47:137-43. [DOI: 10.1080/13693780802144339] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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