期刊
JOURNAL OF FUNGI
卷 8, 期 10, 页码 -出版社
MDPI
DOI: 10.3390/jof8100983
关键词
Candida tropicalis; azole resistance; risk factors
资金
- Siriraj Research Fund [R016333035]
- Faculty of Medicine Siriraj Hospital, Mahidol University
In recent years, there has been a shift in epidemiology from Candida infections to non-albicans species and azole resistance. Factors associated with azole-resistant C. tropicalis isolates include male sex, leukemia, and recent azole administration. 83% of resistant isolates had ERG11 mutations, with A395T being the most common mutation.
In recent decades, an epidemiological shift has been observed from Candida infections to non-albicans species and resistance to azoles. We investigated the associated factors and molecular mechanisms of azole-resistant blood isolates of C. tropicalis. Full-length sequencing of the ERG11 gene and quantitative real-time RT-PCR for the ERG11, MDR1, and CDR1 genes were performed. Male sex (odds ratio, 0.38), leukemia (odds ratio 3.15), and recent administration of azole (odds ratio 10.56) were associated with isolates resistant to azole. ERG11 mutations were found in 83% of resistant isolates, with A395T as the most common mutation (53%). There were no statistically significant differences in the expression of the ERG11, MDR1, and CDR1 genes between the groups resistant and susceptible to azole. The prevalence of azole-resistant isolates was higher than the usage of antifungal drugs, suggesting the possibility of environmental transmission in the healthcare setting. The unknown mechanism of the other 17% of the resistant isolates remains to be further investigated.
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