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Candida kefyr in Kuwait: Prevalence, antifungal drug susceptibility and genotypic heterogeneity
OBJECTIVE: Candida kefyr causes invasive candidiasis in immunocompromised patients, particularly among those with oncohematological diseases. This study determined the prevalence of C. kefyr among yeast isolates collected during 2011–2018 in Kuwait. Antifungal susceptibility testing (AST) and genoty...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591085/ https://www.ncbi.nlm.nih.gov/pubmed/33108361 http://dx.doi.org/10.1371/journal.pone.0240426 |
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author | Ahmad, Suhail Khan, Ziauddin Al-Sweih, Noura Alfouzan, Wadha Joseph, Leena Asadzadeh, Mohammad |
author_facet | Ahmad, Suhail Khan, Ziauddin Al-Sweih, Noura Alfouzan, Wadha Joseph, Leena Asadzadeh, Mohammad |
author_sort | Ahmad, Suhail |
collection | PubMed |
description | OBJECTIVE: Candida kefyr causes invasive candidiasis in immunocompromised patients, particularly among those with oncohematological diseases. This study determined the prevalence of C. kefyr among yeast isolates collected during 2011–2018 in Kuwait. Antifungal susceptibility testing (AST) and genotypic heterogeneity among C. kefyr was also studied. METHODS: Clinical C. kefyr isolates recovered from bloodstream and other specimens during 2011 to 2018 were retrospectively analyzed. All C. kefyr isolates were identified by CHROMagar Candida, Vitek2 and PCR amplification of rDNA. AST was performed by Etest. Molecular basis of resistance to fluconazole and echinocandins was studied by PCR-sequencing of ERG11 and FKS1, respectively. Genotypic heterogeneity was determined with microsatellite-/minisatellite-based primers and for 27 selected isolates by PCR-sequencing of IGS1 region of rDNA. RESULTS: Among 8257 yeast strains, 69 C. kefyr (including four bloodstream) isolates were detected by phenotypic and molecular methods. Isolation from urine and respiratory samples from female and male patients was significantly different (P = 0.001). Four isolates showed reduced susceptibility to amphotericin B and one isolate to all (amphotericin B, fluconazole, voriconazole and caspofungin/micafungin) antifungals tested. Fluconazole-resistant isolate contained only synonymous mutations in ERG11. Echinocandin-resistant isolate contained wild-type hotspot-1 and hotspot-2 of FKS1. Fingerprinting with microsatellite-/minisatellite-based primers identified only three types. IGS1 sequencing identified seven haplotypes among 27 selected isolates. CONCLUSIONS: The overall prevalence of C. kefyr among clinical yeast isolates and among candidemia cases was recorded as 0.83% and 0.32%, respectively. The frequency of isolation of C. kefyr from bloodstream and other invasive samples was stable during the study period. The C. kefyr isolates grown from invasive (bloodstream, bronchoalveolar lavage, abdominal drain fluid, peritonial fluid and gastric fluid) samples and amphotericin B-resistant isolates were genotypically heterogeneous strains. |
format | Online Article Text |
id | pubmed-7591085 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-75910852020-10-30 Candida kefyr in Kuwait: Prevalence, antifungal drug susceptibility and genotypic heterogeneity Ahmad, Suhail Khan, Ziauddin Al-Sweih, Noura Alfouzan, Wadha Joseph, Leena Asadzadeh, Mohammad PLoS One Research Article OBJECTIVE: Candida kefyr causes invasive candidiasis in immunocompromised patients, particularly among those with oncohematological diseases. This study determined the prevalence of C. kefyr among yeast isolates collected during 2011–2018 in Kuwait. Antifungal susceptibility testing (AST) and genotypic heterogeneity among C. kefyr was also studied. METHODS: Clinical C. kefyr isolates recovered from bloodstream and other specimens during 2011 to 2018 were retrospectively analyzed. All C. kefyr isolates were identified by CHROMagar Candida, Vitek2 and PCR amplification of rDNA. AST was performed by Etest. Molecular basis of resistance to fluconazole and echinocandins was studied by PCR-sequencing of ERG11 and FKS1, respectively. Genotypic heterogeneity was determined with microsatellite-/minisatellite-based primers and for 27 selected isolates by PCR-sequencing of IGS1 region of rDNA. RESULTS: Among 8257 yeast strains, 69 C. kefyr (including four bloodstream) isolates were detected by phenotypic and molecular methods. Isolation from urine and respiratory samples from female and male patients was significantly different (P = 0.001). Four isolates showed reduced susceptibility to amphotericin B and one isolate to all (amphotericin B, fluconazole, voriconazole and caspofungin/micafungin) antifungals tested. Fluconazole-resistant isolate contained only synonymous mutations in ERG11. Echinocandin-resistant isolate contained wild-type hotspot-1 and hotspot-2 of FKS1. Fingerprinting with microsatellite-/minisatellite-based primers identified only three types. IGS1 sequencing identified seven haplotypes among 27 selected isolates. CONCLUSIONS: The overall prevalence of C. kefyr among clinical yeast isolates and among candidemia cases was recorded as 0.83% and 0.32%, respectively. The frequency of isolation of C. kefyr from bloodstream and other invasive samples was stable during the study period. The C. kefyr isolates grown from invasive (bloodstream, bronchoalveolar lavage, abdominal drain fluid, peritonial fluid and gastric fluid) samples and amphotericin B-resistant isolates were genotypically heterogeneous strains. Public Library of Science 2020-10-27 /pmc/articles/PMC7591085/ /pubmed/33108361 http://dx.doi.org/10.1371/journal.pone.0240426 Text en © 2020 Ahmad et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Ahmad, Suhail Khan, Ziauddin Al-Sweih, Noura Alfouzan, Wadha Joseph, Leena Asadzadeh, Mohammad Candida kefyr in Kuwait: Prevalence, antifungal drug susceptibility and genotypic heterogeneity |
title | Candida kefyr in Kuwait: Prevalence, antifungal drug susceptibility and genotypic heterogeneity |
title_full | Candida kefyr in Kuwait: Prevalence, antifungal drug susceptibility and genotypic heterogeneity |
title_fullStr | Candida kefyr in Kuwait: Prevalence, antifungal drug susceptibility and genotypic heterogeneity |
title_full_unstemmed | Candida kefyr in Kuwait: Prevalence, antifungal drug susceptibility and genotypic heterogeneity |
title_short | Candida kefyr in Kuwait: Prevalence, antifungal drug susceptibility and genotypic heterogeneity |
title_sort | candida kefyr in kuwait: prevalence, antifungal drug susceptibility and genotypic heterogeneity |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7591085/ https://www.ncbi.nlm.nih.gov/pubmed/33108361 http://dx.doi.org/10.1371/journal.pone.0240426 |
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