Genetic relatedness among azole-resistant Candida tropicalis clinical strains in Taiwan from 2014 to 2018

Zi Li Zhou; Kuo Yun Tseng; Yin Zhi Chen; De Jiun Tsai; Chi Jung Wu; Yee Chun Chen; Hwei Ling Peng; Yun Liang Yang; Li Yun Hsieh; Chang Hua Chen; Che Han Hsu; Lih Shinn Wang; Ming Fang Cheng; Gwo Jong Hsu; Chin Chuan Kao; Bor Shen Hu; Yuan Ti Lee; Jien-Wei Liu; Keh Sen Liu; Wei Chieh Miu; Hui Ming Yang; Yen Cheng Yeh; Hsiu Jung Lo

doi:10.1016/j.ijantimicag.2022.106592

Genetic relatedness among azole-resistant Candida tropicalis clinical strains in Taiwan from 2014 to 2018

Zi Li Zhou, Kuo Yun Tseng, Yin Zhi Chen, De Jiun Tsai, Chi Jung Wu, Yee Chun Chen, Hwei Ling Peng, Yun Liang Yang, Li Yun Hsieh, Chang Hua Chen, Che Han Hsu, Lih Shinn Wang, Ming Fang Cheng, Gwo Jong Hsu, Chin Chuan Kao, Bor Shen Hu, Yuan Ti Lee, Jien-Wei Liu, Keh Sen Liu, Wei Chieh MiuHui Ming Yang, Yen Cheng Yeh, Hsiu Jung Lo^*

^*Corresponding author for this work

Research output: Contribution to journal › Journal Article › peer-review

10 Scopus citations

Abstract

To monitor trends in the distribution of yeast species and the susceptibilities of these species to commonly prescribed antifungal drugs, we conduct the Taiwan Surveillance of Antimicrobial Resistance of Yeasts (TSARY) every 4 years. We found that 25 of 294 Candida tropicalis isolates from TSARY 2014 and 31 of 314 C. tropicalis isolates from TSARY 2018 were resistant to fluconazole. We determined the genetic relatedness among fluconazole-resistant C. tropicalis isolates by multilocus sequence typing (MLST). Among 174 C. tropicalis isolates, including all 56 fluconazole-resistant, all 26 susceptible-dose dependent and 92 selected fluconazole-susceptible isolates, 59 diploid sequence types (DSTs) were identified. We found that 22 of the 25 fluconazole-resistant C. tropicalis from TSARY 2014 and 29 of the 31 fluconazole-resistant C. tropicalis from TSARY 2018 were genetically related and belonged to the same cluster (clade 4). A combination of mutation and overexpression of ERG11, encoding the target of azole drugs, was the major mechanism contributing to drug resistance. Approximately two-thirds of reviewed patients infected or colonised by fluconazole-resistant C. tropicalis were azole-naïve. Furthermore, there was no evidence of patient-to-patient transmission. Because the clade 4 fluconazole-resistant C. tropicalis strain persists in Taiwan, it is important to identify the source of azole-resistant C. tropicalis to prevent the spread of this resistant strain.

Original language	English
Article number	106592
Journal	International Journal of Antimicrobial Agents
Volume	59
Issue number	6
DOIs	https://doi.org/10.1016/j.ijantimicag.2022.106592
State	Published - 06 2022
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2022 Elsevier Ltd

Keywords

Antifungal resistance
Candida species
DST
Fluconazole
Multilocus sequence typing
Pathogenic yeasts

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.ijantimicag.2022.106592

Cite this

Zhou, Z. L., Tseng, K. Y., Chen, Y. Z., Tsai, D. J., Wu, C. J., Chen, Y. C., Peng, H. L., Yang, Y. L., Hsieh, L. Y., Chen, C. H., Hsu, C. H., Wang, L. S., Cheng, M. F., Hsu, G. J., Kao, C. C., Hu, B. S., Lee, Y. T., Liu, J.-W., Liu, K. S., ... Lo, H. J. (2022). Genetic relatedness among azole-resistant Candida tropicalis clinical strains in Taiwan from 2014 to 2018. International Journal of Antimicrobial Agents, 59(6), Article 106592. https://doi.org/10.1016/j.ijantimicag.2022.106592

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title = "Genetic relatedness among azole-resistant Candida tropicalis clinical strains in Taiwan from 2014 to 2018",

abstract = "To monitor trends in the distribution of yeast species and the susceptibilities of these species to commonly prescribed antifungal drugs, we conduct the Taiwan Surveillance of Antimicrobial Resistance of Yeasts (TSARY) every 4 years. We found that 25 of 294 Candida tropicalis isolates from TSARY 2014 and 31 of 314 C. tropicalis isolates from TSARY 2018 were resistant to fluconazole. We determined the genetic relatedness among fluconazole-resistant C. tropicalis isolates by multilocus sequence typing (MLST). Among 174 C. tropicalis isolates, including all 56 fluconazole-resistant, all 26 susceptible-dose dependent and 92 selected fluconazole-susceptible isolates, 59 diploid sequence types (DSTs) were identified. We found that 22 of the 25 fluconazole-resistant C. tropicalis from TSARY 2014 and 29 of the 31 fluconazole-resistant C. tropicalis from TSARY 2018 were genetically related and belonged to the same cluster (clade 4). A combination of mutation and overexpression of ERG11, encoding the target of azole drugs, was the major mechanism contributing to drug resistance. Approximately two-thirds of reviewed patients infected or colonised by fluconazole-resistant C. tropicalis were azole-na{\"i}ve. Furthermore, there was no evidence of patient-to-patient transmission. Because the clade 4 fluconazole-resistant C. tropicalis strain persists in Taiwan, it is important to identify the source of azole-resistant C. tropicalis to prevent the spread of this resistant strain.",

keywords = "Antifungal resistance, Candida species, DST, Fluconazole, Multilocus sequence typing, Pathogenic yeasts",

author = "Zhou, {Zi Li} and Tseng, {Kuo Yun} and Chen, {Yin Zhi} and Tsai, {De Jiun} and Wu, {Chi Jung} and Chen, {Yee Chun} and Peng, {Hwei Ling} and Yang, {Yun Liang} and Hsieh, {Li Yun} and Chen, {Chang Hua} and Hsu, {Che Han} and Wang, {Lih Shinn} and Cheng, {Ming Fang} and Hsu, {Gwo Jong} and Kao, {Chin Chuan} and Hu, {Bor Shen} and Lee, {Yuan Ti} and Jien-Wei Liu and Liu, {Keh Sen} and Miu, {Wei Chieh} and Yang, {Hui Ming} and Yeh, {Yen Cheng} and Lo, {Hsiu Jung}",

note = "Publisher Copyright: {\textcopyright} 2022 Elsevier Ltd",

year = "2022",

month = jun,

doi = "10.1016/j.ijantimicag.2022.106592",

language = "英语",

volume = "59",

journal = "International Journal of Antimicrobial Agents",

issn = "0924-8579",

publisher = "Elsevier B.V.",

number = "6",

}

Zhou, ZL, Tseng, KY, Chen, YZ, Tsai, DJ, Wu, CJ, Chen, YC, Peng, HL, Yang, YL, Hsieh, LY, Chen, CH, Hsu, CH, Wang, LS, Cheng, MF, Hsu, GJ, Kao, CC, Hu, BS, Lee, YT, Liu, J-W, Liu, KS, Miu, WC, Yang, HM, Yeh, YC & Lo, HJ 2022, 'Genetic relatedness among azole-resistant Candida tropicalis clinical strains in Taiwan from 2014 to 2018', International Journal of Antimicrobial Agents, vol. 59, no. 6, 106592. https://doi.org/10.1016/j.ijantimicag.2022.106592

TY - JOUR

T1 - Genetic relatedness among azole-resistant Candida tropicalis clinical strains in Taiwan from 2014 to 2018

AU - Zhou, Zi Li

AU - Tseng, Kuo Yun

AU - Chen, Yin Zhi

AU - Tsai, De Jiun

AU - Wu, Chi Jung

AU - Chen, Yee Chun

AU - Peng, Hwei Ling

AU - Yang, Yun Liang

AU - Hsieh, Li Yun

AU - Chen, Chang Hua

AU - Hsu, Che Han

AU - Wang, Lih Shinn

AU - Cheng, Ming Fang

AU - Hsu, Gwo Jong

AU - Kao, Chin Chuan

AU - Hu, Bor Shen

AU - Lee, Yuan Ti

AU - Liu, Jien-Wei

AU - Liu, Keh Sen

AU - Miu, Wei Chieh

AU - Yang, Hui Ming

AU - Yeh, Yen Cheng

AU - Lo, Hsiu Jung

PY - 2022/6

Y1 - 2022/6

N2 - To monitor trends in the distribution of yeast species and the susceptibilities of these species to commonly prescribed antifungal drugs, we conduct the Taiwan Surveillance of Antimicrobial Resistance of Yeasts (TSARY) every 4 years. We found that 25 of 294 Candida tropicalis isolates from TSARY 2014 and 31 of 314 C. tropicalis isolates from TSARY 2018 were resistant to fluconazole. We determined the genetic relatedness among fluconazole-resistant C. tropicalis isolates by multilocus sequence typing (MLST). Among 174 C. tropicalis isolates, including all 56 fluconazole-resistant, all 26 susceptible-dose dependent and 92 selected fluconazole-susceptible isolates, 59 diploid sequence types (DSTs) were identified. We found that 22 of the 25 fluconazole-resistant C. tropicalis from TSARY 2014 and 29 of the 31 fluconazole-resistant C. tropicalis from TSARY 2018 were genetically related and belonged to the same cluster (clade 4). A combination of mutation and overexpression of ERG11, encoding the target of azole drugs, was the major mechanism contributing to drug resistance. Approximately two-thirds of reviewed patients infected or colonised by fluconazole-resistant C. tropicalis were azole-naïve. Furthermore, there was no evidence of patient-to-patient transmission. Because the clade 4 fluconazole-resistant C. tropicalis strain persists in Taiwan, it is important to identify the source of azole-resistant C. tropicalis to prevent the spread of this resistant strain.

AB - To monitor trends in the distribution of yeast species and the susceptibilities of these species to commonly prescribed antifungal drugs, we conduct the Taiwan Surveillance of Antimicrobial Resistance of Yeasts (TSARY) every 4 years. We found that 25 of 294 Candida tropicalis isolates from TSARY 2014 and 31 of 314 C. tropicalis isolates from TSARY 2018 were resistant to fluconazole. We determined the genetic relatedness among fluconazole-resistant C. tropicalis isolates by multilocus sequence typing (MLST). Among 174 C. tropicalis isolates, including all 56 fluconazole-resistant, all 26 susceptible-dose dependent and 92 selected fluconazole-susceptible isolates, 59 diploid sequence types (DSTs) were identified. We found that 22 of the 25 fluconazole-resistant C. tropicalis from TSARY 2014 and 29 of the 31 fluconazole-resistant C. tropicalis from TSARY 2018 were genetically related and belonged to the same cluster (clade 4). A combination of mutation and overexpression of ERG11, encoding the target of azole drugs, was the major mechanism contributing to drug resistance. Approximately two-thirds of reviewed patients infected or colonised by fluconazole-resistant C. tropicalis were azole-naïve. Furthermore, there was no evidence of patient-to-patient transmission. Because the clade 4 fluconazole-resistant C. tropicalis strain persists in Taiwan, it is important to identify the source of azole-resistant C. tropicalis to prevent the spread of this resistant strain.

KW - Antifungal resistance

KW - Candida species

KW - DST

KW - Fluconazole

KW - Multilocus sequence typing

KW - Pathogenic yeasts

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U2 - 10.1016/j.ijantimicag.2022.106592

DO - 10.1016/j.ijantimicag.2022.106592

M3 - 文章

C2 - 35460852

AN - SCOPUS:85130409636

SN - 0924-8579

VL - 59

JO - International Journal of Antimicrobial Agents

JF - International Journal of Antimicrobial Agents

IS - 6

M1 - 106592

ER -

Genetic relatedness among azole-resistant Candida tropicalis clinical strains in Taiwan from 2014 to 2018

Abstract

Bibliographical note

Keywords

UN SDGs

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