Candida Genotyping of Blood Culture Isolates from Patients Admitted to 16 Hospitals in Madrid: Genotype Spreading during the COVID-19 Pandemic Driven by Fluconazole-Resistant C. parapsilosis

• Published in: Journal of fungi (Basel) Vol. 8; no. 11; p. 1228
• Main Authors: Díaz-García, Judith, Gómez, Ana, Machado, Marina, Alcalá, Luis, Reigadas, Elena, Sánchez-Carrillo, Carlos, Pérez-Ayala, Ana, de la Pedrosa, Elia Gómez-García, González-Romo, Fernando, Cuétara, María Soledad, García-Esteban, Coral, Quiles-Melero, Inmaculada, Zurita, Nelly Daniela, Algarra, María Muñoz, Durán-Valle, María Teresa, Sánchez-García, Aída, Muñoz, Patricia, Escribano, Pilar, Guinea, Jesús, On Behalf Of The Candimad Study Group
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 21-11-2022; MDPI
• Subjects: Abdomen; Blood culture; Candida; candidaemia; Candidemia; Candidiasis; Cluster analysis; Coronaviruses; COVID-19; Disease transmission; Epidemiology; Fluconazole; Genetic markers; Genotype & phenotype; Genotypes; Genotyping; Hematology; Hospitals; intra-abdominal samples; microsatellite genotyping; Microsatellites; Nosocomial infections; Pandemics; Patients; Statistical significance; United States > US; Madrid Spain; Spain; COVID-19; Candida; Madrid; candidaemia; intra-abdominal samples; blood culture; microsatellite genotyping
• ISSN: 2309-608X; 2309-608X
• DOI: 10.3390/jof8111228

Candidaemia and invasive candidiasis are typically hospital-acquired. Genotyping isolates from patients admitted to different hospitals may be helpful in tracking clones spreading across hospitals, especially those showing antifungal resistance.
We characterized
clusters by studying
isolates (
,
= 1041;
,
= 354, and
,
= 125) from blood cultures (53.8%) and intra-abdominal samples (46.2%) collected as part of the CANDIMAD (
in Madrid) study in Madrid (2019-2021). Species-specific microsatellite markers were used to define the genotypes of
spp. found in a single patient (singleton) or several patients (cluster) from a single hospital (intra-hospital cluster) or different hospitals (widespread cluster).
We found 83 clusters, of which 20 were intra-hospital, 49 were widespread, and 14 were intra-hospital and widespread. Some intra-hospital clusters were first detected before the onset of the COVID-19 pandemic, but the number of clusters increased during the pandemic, especially for
. The proportion of widespread clusters was significantly higher for genotypes found in both compartments than those exclusively found in either the blood cultures or intra-abdominal samples. Most
and
-resistant genotypes were singleton and presented exclusively in either blood cultures or intra-abdominal samples. Fluconazole-resistant
isolates belonged to intra-hospital clusters harboring either the Y132F or G458S ERG11p substitutions; the dominant genotype was also widespread.
the number of clusters-and patients involved-increased during the COVID-19 pandemic mainly due to the emergence of fluconazole-resistant
genotypes.