Introduction: The Candida parapsilosiscomplex can be divided into C. parapsilosis sensu stricto, C. orthopsilosis, and C. metapsilosis subtypes. C. parapsilosis complex is the most predominant pathogen in the non-Candida albicans family. It is uncommon for drug sensitivity tests to type them. In routine susceptibility reports, drug susceptibility of C. parapsilosis complex subtypes is lacking.
Aim: This study aims to investigate the antifungal
susceptibility and clinical distribution characteristics of the C. parapsilosis complex subtypes causing
deep infection in patients.
Methodology: Non-repetitive strains of C. parapsilosis complex isolated from deep infection from 2017 to
2019 were collected. Blood culture, cerebrospinal fluid culture, and pus
culture were enriched in a liquid medium. Species-level identification was
performed using a matrix-assisted laser desorption/ionization time-of-flight
mass spectrometer and confirmed using ITS gene sequencing, when necessary.
Antifungal susceptibility testing was performed using the Sensititre YeastOne
system method.
Results: A total of 244 cases were included in the study,
including 176 males (72.13%, 60.69±13.43 years) and 68 females (27.87%,
60.21±10.59 years). The primary diseases were cancer (43.44%), cardiovascular
disease (25.00%), digestive system diseases, (18.44%), infection (6.97%), and
nephropathy (6.15%). Strains were isolated from the bloodstream (63.11%),
central venous catheters (15.16%), pus (6.56%), ascites (5.74%), sterile body
fluid (5.33%), and bronchoalveolar lavage fluid (BALF, 4.09%). Of the 244 C. parapsilosis complex strains, 179
(73.26%) were identified as C.
parapsilosis sensu stricto, 62 (25.41%) were C. orthopsilosis, and three (1.23%) were C. metapsilosis. Only one C.
parapsilosis sensu stricto strain was resistant to anidu- lafungin,
micafungin, caspofungin, and voriconazole, and it was non-wild-type (NWT) to
amphotericin B. Furthermore, six C.
parapsilosis sensu stricto strains were resistant to fluconazole, and one
was dose-dependent susceptible. Five C.
parapsilosis sensu stricto strains were NWT to posaconazole. Only one C. orthopsilosis strain was NWT for
anidulafungin, micafungin, caspofungin, fluconazole, voriconazole, amphotericin
B, and posaconazole, while the rest of the strains were wild-type. C. parapsilosis often leads to severe
fungal infection in patients with low immune function, especially in children
with low birth weight under 2 years old. In the present study, most of the
infected population were cancer patients, accounting for nearly half of the
samples, confirming that impaired immunity is a risk factor for C. parapsilosis sensu stricto infection.
Conclusion: C.
parapsilosis sensu stricto was the main clinical isolate from the C. parapsilosis complex in our hospital.
Most strains were isolated from the bloodstream. The susceptibility rate to
commonly used antifungal drugs was more than 96%. Furthermore, most of the
infected patients were elderly male cancer patients. In summary, C. parapsilosis complex is a common
clinical invasive infecting Candida pathogen that requires continuous attention
to its epidemiological characteristics and mastering of its clinical threat
evolution.
Author (s) Details
Wei Zhang
Clinical Laboratory, The First Affiliated Hospital of Hebei North
University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou City, 075000,
Hebei Province, PR China and Clinical Laboratory, State Key Laboratory of
Complex Severe and Rare Diseases, Beijing, 100730, PR China.
Minghua Zhan
Clinical Laboratory, The First Affiliated Hospital of Hebei North
University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou City, 075000,
Hebei Province, PR China and Clinical Laboratory Diagnostics, Peking University
People’s Hospital, 11 Xizhimen South Street, Beijing, 100044, PR China.
Na Wang
Clinical Laboratory, The First Affiliated Hospital of Hebei North
University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou City, 075000,
Hebei Province, PR China.
Jingjing Fan
Infectious Disease Department, The First Affiliated Hospital of Hebei North
University, No. 12, 15 Changqing Road, Qiaoxi District, Zhangjiakou City,
075000, Hebei Province, PR China.
Xuying Han
Clinical Laboratory, The First Affiliated Hospital of Hebei North
University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou City, 075000,
Hebei Province, PR China.
Caiqing Li
Clinical Laboratory, The First Affiliated Hospital of Hebei North
University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou City, 075000,
Hebei Province, PR China.
Jinlu Liu
Clinical Laboratory, The First Affiliated Hospital of Hebei North
University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou City, 075000,
Hebei Province, PR China.
Jia Li
Clinical Laboratory, The First Affiliated Hospital of Hebei North
University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou City, 075000,
Hebei Province, PR China.
Yongwang Hou
Clinical Laboratory, The First Affiliated Hospital of Hebei North
University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou City, 075000,
Hebei Province, PR China.
Xinsheng Wang
Clinical Laboratory, The First Affiliated Hospital of Hebei North
University, No. 12, Changqing Road, Qiaoxi District, Zhangjiakou City, 075000,
Hebei Province, PR China.
Zhihua Zhang
Respiratory and Critical Care Medicine Intensive Care Unit, The First
Affiliated Hospital of Hebei North University, No. 12, Changqing Road, Qiaoxi
District, Zhangjiakou City, 075000, Hebei Province, PR China.
Please see the book here:- https://doi.org/10.9734/bpi/rpmab/v8/2285
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