Global Emergence of Resistance to Fluconazole and Voriconazole in Candida parapsilosis in Tertiary Hospitals in Spain During the OVID-19 Pandemic
Trevijano-Contador, Nuria (Instituto de Salud Carlos III)
Torres-Cano, Alba (Instituto de Salud Carlos III)
Carballo-González, Cristina (Instituto de Salud Carlos III)
Puig-Asensio, Mireia (Hospital Universitari de Bellvitge)
Martin-Gomez, M. Teresa (Hospital Universitari Vall d'Hebron)
Jiménez-Martínez, Emilio (Hospital Universitari Vall d'Hebron)
Romero, Daniel (Hospital Universitari Vall d'Hebron)
Nuvials, Xavier (Hospital Universitari Vall d'Hebron)
Olmos-Arenas, Roberto (Hospital Universitari de Bellvitge)
Moretó-Castellsagué, María Clara (Hospital Universitari de Bellvitge)
Fernández-Delgado, Lucía (Hospital Universitari de Bellvitge)
Rodríguez-Sevilla, Graciela (Hospital Universitari de Bellvitge)
Aguilar-Sánchez, María-Mercedes (Hospital Universitari de Bellvitge)
Ayats-Ardite, Josefina (Hospital Universitari de Bellvitge)
Ardanuy, Carmen (Hospital Universitari de Bellvitge)
Sanchez-Romero, Isabel (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Muñoz-Algarra, María (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Merino-Amador, Paloma (Hospital Universitario Clínico San Carlos (Madrid))
González-Romo, Fernando (Hospital Universitario Clínico San Carlos (Madrid))
Megías-Lobón, Gregoria (Hospital Universitario de Burgos)
García-Campos, Jose Angel (Hospital Universitario de Burgos)
Mantecón-Vallejo, María Ángeles (Hospital Universitario de Burgos)
Alcoceba, Eva (Hospital Universitari Son Espases (Palma de Mallorca, Balears))
Escribano Martos, Pilar (Hospital General Universitario Gregorio Marañón)
Guinea, Jesús (Hospital General Universitario Gregorio Marañón. Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM))
Durán-Valle, Maria Teresa (Hospital Universitario de Móstoles (Madrid))
Fraile-Torres, Arturo (Hospital Universitario de Móstoles (Madrid))
Roiz-Mesones, María Pía (Hospital Universitario Marqués de Valdecilla (Santander, Cantabria))
Lara-Plaza, Isabel (Hopsital Universitario de Móstoles)
de Ayala, Ana Pérez (Hospital Universitario 12 de Octubre (Madrid))
Simón-Sacristán, María (Hospital Central de la Defensa Gómez Ulla)
Collazos-Blanco, Ana (Hospital Central de la Defensa Gómez Ulla)
Nebreda-Mayoral, Teresa (Hospital Clínico Universitario de Valladolid)
March-Roselló, Gabriel (Hospital Clínico Universitario de Valladolid)
Alcázar-Fuoli, Laura
Zaragoza, Óscar (Instituto de Salud Carlos III)
Universitat Autònoma de Barcelona

Data:	2022
Resum:	Candida parapsilosis is a frequent cause of candidemia worldwide. Its incidence is associated with the use of medical implants, such as central venous catheters or parenteral nutrition. This species has reduced susceptibility to echinocandins, and it is susceptible to polyenes and azoles. Multiple outbreaks caused by fluconazole-nonsusceptible strains have been reported recently. A similar trend has been observed among the C. parapsilosis isolates received in the last 2 years at the Spanish Mycology Reference Laboratory. Yeast were identified by molecular biology, and antifungal susceptibility testing was performed using the European Committee on Antimicrobial Susceptibility Testing protocol. The ERG11 gene was sequenced to identify resistance mechanisms, and strain typing was carried out by microsatellite analysis. We examined the susceptibility profile of 1315 C. parapsilosis isolates available at our reference laboratory between 2000 and 2021, noticing an increase in the number of isolates with acquired resistance to fluconazole, and voriconazole has increased in at least 8 different Spanish hospitals in 2020-2021. From 121 recorded clones, 3 were identified as the most prevalent in Spain (clone 10 in Catalonia and clone 96 in Castilla-Leon and Madrid, whereas clone 67 was found in 2 geographically unrelated regions, Cantabria and the Balearic Islands). Our data suggest that concurrently with the coronavirus disease 2019 pandemic, a selection of fluconazole-resistant C. parapsilosis isolates has occurred in Spain, and the expansion of specific clones has been noted across centers. Further research is needed to determine the factors that underlie the successful expansion of these clones and their potential genetic relatedness.
Ajuts:	Agencia Estatal de Investigación SAF2017-86912-R Agencia Estatal de Investigación PID2020-114546RB-I00 Ministerio de Sanidad y Consumo CB06/06/0037 Ministerio de Sanidad y Consumo CB06/06/0058
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Candida parapsilosis ; Antifungal resistance ; Fluconazole ; Outbreaks ; Voriconazole
Publicat a:	Open Forum Infectious Diseases, Vol. 9 (november 2022) , ISSN 2328-8957

DOI: 10.1093/ofid/ofac605
PMID: 36467290

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