| Autor: |
Francisco EC; Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo , São Paulo, Brazil., Ribeiro FC; Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo , São Paulo, Brazil., Almeida Junior JN; Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo , São Paulo, Brazil., Pedoni DB; Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo , São Paulo, Brazil., da Matta DA; Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo , São Paulo, Brazil., Dolande M; Department of Mycology, Instituto Nacional de Higiene Rafael Rangel , Caracas, Venezuela., Melo ASA; Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo , São Paulo, Brazil., Lima RF; Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo , São Paulo, Brazil., Aquino VR; Hospital de Clínicas, Universidade Federal do Rio , Porto Alegre, Grande do Sul, Brazil., Corzo-León DE; MRC Centre for Medical Mycology, University of Exeter , Exeter, United Kingdom., Zurita J; Unidad de Investigaciones en Biomedicina, Zurita & Zurita Laboratorios , Quito, Ecuador.; Facultad de Medicina, Pontificia Universidad Catolica del Ecuador , Quito, Ecuador., Cortes JA; Facultad de Medicina, Universidad Nacional de Colombia, Sede Bogotá , Bogotá, Colombia., Nucci M; Departamento de Clínica Médica, Universidade Federal do Rio de Janeiro , Rio de Janeiro, Brazil., Colombo AL; Laboratório Especial de Micologia, Disciplina de Infectologia, Universidade Federal de São Paulo , São Paulo, Brazil. |
| Abstrakt: |
Members of the Meyerozyma guilliermondii species complex are able to cause superficial and life-threatening systemic infections with low susceptibility to azoles and echinocandins. We tested 130 bloodstream M. guilliermondii complex isolates collected from eight Latin American medical centers over 18 years (period 1 = 2000-2008 and period 2 = 2009-2018) to investigate trends in species distribution and antifungal resistance. The isolates were identified by rDNA ITS region sequencing, and antifungal susceptibility tests were performed against fluconazole, voriconazole, anidulafungin, and amphotericin B using the CLSI microbroth method. M. guilliermondii sensu stricto (s.s.; n = 116) was the most prevalent species, followed by Meyerozyma caribbica ( n = 12) and Meyerozyma carpophila ( n = 2). Based on rDNA ITS identification, three clades within M. guilliermondii sensu stricto were characterized (clade 1 n = 94; clade 2 n = 19; and clade 3 n = 3). In the second period of study, we found a substantial increment in the isolation of M. caribbica (3.4% versus 13.8%; P = 0.06) and clade 2 M. guilliermondii s.s. exhibiting lower susceptibility to one or more triazoles. IMPORTANCE Yeast-invasive infections play a relevant role in human health, and there is a concern with the emergence of non- Candida pathogens causing disease worldwide. There is a lack of studies addressing the prevalence and antifungal susceptibility of different species within the M. guilliermondii complex that cause invasive infections. We evaluated 130 episodes of M. guilliermondii species complex candidemia documented in eight medical centers over 18 years. We detected the emergence of less common species within the Meyerozyma complex causing candidemia and described a new clade of M. guilliermondii with limited susceptibility to triazoles. These results support the relevance of continued global surveillance efforts to early detect, characterize, and report emergent fungal pathogens exhibiting limited susceptibility to antifungals. |
