Candida auris in various hospitals across Kuwait and their susceptibility and molecular basis of resistance to antifungal drugs.

Autor: Ahmad S; Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait., Khan Z; Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait., Al-Sweih N; Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait., Alfouzan W; Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait., Joseph L; Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait.
Jazyk: angličtina
Zdroj: Mycoses [Mycoses] 2020 Jan; Vol. 63 (1), pp. 104-112. Date of Electronic Publication: 2019 Nov 03.
DOI: 10.1111/myc.13022
Abstrakt: Background: Candida auris, a multidrug-resistant species, has the propensity of nosocomial transmission despite normal decontamination procedures. Here, we describe the isolation of C auris from patients in various hospitals in Kuwait during 2014-2018. Susceptibility to antifungal drugs and molecular basis of resistance to fluconazole, voriconazole and micafungin were also studied.
Methods: Candida auris (n = 314) obtained from 126 patients in eight hospitals were studied. All isolates were identified by PCR amplification and/or PCR-sequencing of ribosomal DNA (rDNA). Antifungal susceptibility was determined by Etest. Molecular basis of resistance to fluconazole and micafungin was studied by PCR-sequencing of ERG11 and FKS1 genes, respectively.
Findings: Bloodstream (n = 58), urine (n = 124), respiratory (n = 98) and other (n = 34) specimens yielded 314 C auris isolates. The proportion of bloodstream C auris among all yeast isolates was higher (42 of 307, 13.7%) in 2018 as compared to 2014-2017 (16 of 964, 1.7%) (P = .001). More bloodstream isolates (42 of 139) were cultured in 2018 than during 2014-2017 (16 of 175) (P = .001). Resistance to amphotericin B, fluconazole, voriconazole and micafungin was detected in 27.1%, 100%, 41.1% and 1.7% isolates, respectively. Fluconazole-resistant isolates contained either Y132F or K143R mutation in ERG11. Isolates with K143R mutation were additionally resistant to voriconazole. Micafungin-resistant isolates contained S639F mutation in hot spot 1 of FKS1.
Conclusions: Our study highlights spreading of C auris in major hospitals across Kuwait and its increasing role as a bloodstream pathogen in 2018. Cross-resistance to voriconazole was also seen in isolates with K143R mutation in ERG11, while micafungin-resistant isolates harboured S639F mutation in hot spot 1 of FKS1.
(© 2019 Blackwell Verlag GmbH.)
Databáze: MEDLINE
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