Increasing Prevalence of Multidrug-Resistant Candida haemulonii Species Complex among All Yeast Cultures Collected by a Reference Laboratory over the Past 11 Years

• Published in: Journal of fungi (Basel) Vol. 6; no. 3; p. 110
• Main Authors: Lima, Soraia Lopes, Francisco, Elaine Cristina, de Almeida Junior, Joao Nobrega, de Castro Lima Santos, Daniel Wagner, Carlesse, Fabiane, Queiroz-Telles, Flavio, Melo, Analy Salles De Azevedo, Colombo, Arnaldo Lopes
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 01.09.2020; MDPI
• Subjects: Amphotericin B; antifungal resistance; Biopsy; Candida; Candida haemulonii species complex; candidemia; Catheters; cryptic Candida species; Fluconazole; Health aspects; Identification; Infections; Laboratories; Multidrug resistance; nosocomial fungal infections; Pathogens; Patients; Species; Trends; Voriconazole; Brazil; United States > US
• ISSN: 2309-608X; 2309-608X
• DOI: 10.3390/jof6030110

There is worldwide concern with the increasing rates of infections due to multiresistant Candida isolates reported in tertiary medical centers. We checked for historical trends in terms of prevalence rates and antifungal susceptibility of the Candida haemulonii species complex in our yeast stock culture collected during the last 11 years. The isolates were identified by sequencing the rDNA internal transcribed spacer (ITS) region, and antifungal susceptibility tests for amphotericin B, voriconazole, fluconazole, anidulafungin, and 5-fluorocytosine were performed by the Clinical and Laboratory Standards Institute (CLSI) microbroth method. A total of 49 isolates were identified as Candida haemulonii sensu stricto (n = 21), followed by C. haemulonii var. vulnera (n = 15) and C. duobushaemulonii (n = 13), including 38 isolates cultured from patients with deep-seated Candida infections. The prevalence of the C. haemulonii species complex increased from 0.9% (18 isolates among 1931) in the first period (December 2008 to June 2013) to 1.7% (31 isolates among 1868) in the second period (July 2014 to December 2019) of analysis (p = 0.047). All isolates tested exhibited high minimum inhibition concentrations for amphotericin B and fluconazole, but they remained susceptible to 5-fluorocytosine and anidulafungin. We were able to demonstrate the increased isolation of the multiresistant Candida haemulonii species complex in our culture collection, where most isolates were cultured from patients with deep-seated infections.