Antifungal susceptibility profile of Candida clinical isolates from 22 hospitals of São Paulo State, Brazil

Author(s)

Rodrigues, D. K. B. ^[1] ; Bonfietti, L. X. ^[1] ; Garcia, R. A. ^[1] ; Araujo, M. R. ^[1] ; Rodrigues, J. S. ^[1] ; Gimenes, V. M. F. ^[2] ; Melhem, M. S. C. ^{[1, 3]}

Affiliation

^[1] Adolfo Lutz Inst, Secretaria Saude, Nucleo Micol, Sao Paulo, SP - Brazil

^[2] Univ Sao Paulo, Inst Med Trop, Lab Micol Med LIM 53, Sao Paulo, SP - Brazil

^[3] Univ Fed Mato Grosso do Sul, Escola Med, Campo Grande, MS - Brazil

• Document type: Journal article
• Source: Brazilian Journal of Medical and Biological Research; v. 54, n. 9 2021.
• Web of Science Citations: 0

Abstract

This study aimed to evaluate the frequency of cryptic Candida species from candidemia cases in 22 public hospitals in São Paulo State, Brazil, and their antifungal susceptibility profiles. During 2017 and 2018, 144 isolates were molecularly identified as 14 species; C. parapsilosis (32.6%), C. albicans (27.7%), C. tropicalis (14.6%), C. glabrata (9.7%), C. krusei (2.8%), C. orthopsilosis (2.8%), C. haemulonii var. vulnera (2.1%), C. haemulonii (1.4%), C. metapsilosis (1.4%), C. dubliniensis (1.4%), C. guilliermondii (1.4%), C. duobushaemulonii (0.7%), C. kefyr (0.7%), and C. pelliculosa (0.7%). Poor susceptibility to fluconazole was identified in 6.4% of C. parapsilosis isolates (0.12 to >64 µg/mL), 50% of C. guilliermondii (64 µg/mL), 66.6% of C. haemulonii var. vulnera (16-32 µg/mL), and C. duobushaemulonii strain (MIC 64 µg/mL). Our results corroborated the emergence of C. glabrata in Brazilian cases of candidemia as previously reported. Importantly, we observed a large proportion of non-wild type C. glabrata isolates to voriconazole (28.6%; <0.015 to 4 µg/mL) all of which were also resistant to fluconazole (28.6%). Of note, C. haemulonii, a multidrug resistant species, has emerged in the Southeast region of Brazil. Our findings suggested a possible epidemiologic change in the region with an increase in fluconazole-resistant species causing candidemia. We stress the relevance of routine accurate identification to properly manage therapy and monitor epidemiologic trends. (AU)

• FAPESP's process: 17/50333-7 - Institutional research development plan of the Instituto Adolfo Lutz (PDIp)
• Grantee: Carlos Henrique Camargo
• Support Opportunities: Research Grants - State Research Institutes Modernization Program
• FAPESP's process: 18/18996-9 - Cryptic Candida species among bloodstream isolates: identification and susceptibility pattern to azole drugs
• Grantee: Dality Keffelen de Barros Rodrigues
• Support Opportunities: Scholarships in Brazil - Master