Trends in antifungal resistance in Candida from a multicenter study conducted in Madrid (CANDIMAD study): fluconazole-resistant C. parapsilosis spreading has gained traction in 2022.

Autor:	Díaz-García J; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón , Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón , Madrid, Spain., Machado M; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón , Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón , Madrid, Spain., Alcalá L; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón , Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón , Madrid, Spain.; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058) , Madrid, Spain., Reigadas E; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón , Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón , Madrid, Spain.; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058) , Madrid, Spain., Pérez-Ayala A; Hospital Universitario 12 de Octubre , Madrid, Spain.; Instituto de Investigación Sanitaria del Hospital 12 de Octubre , Madrid, Spain., Gómez-García de la Pedrosa E; Hospital Universitario Ramón y Cajal , Madrid, Spain.; Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS) , Madrid, Spain.; CIBER de Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III , Madrid, Spain., Gónzalez-Romo F; Hospital Universitario Clínico San Carlos , Madrid, Spain.; Instituto de Investigación Sanitaria del Hospital Clínico San Carlos IdISSC , Madrid, Spain., Cuétara MS; Hospital Universitario Severo Ochoa , Leganés, Spain., García-Esteban C; Hospital Universitario de Getafe , Getafe, Spain., Quiles-Melero I; Hospital Universitario La Paz , Madrid, Spain., Zurita ND; Hospital Universitario de La Princesa , Madrid, Spain., Muñoz-Algarra M; Hospital Universitario Puerta de Hierro , Majadahonda, Spain., Durán-Valle MT; Hospital Universitario de Móstoles , Móstoles, Spain., Sánchez-García A; Laboratorio Central de la CAM-URSalud-Hospital Infanta Sofía , San Sebastián de los Reyes, Spain., Muñoz P; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón , Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón , Madrid, Spain.; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058) , Madrid, Spain.; Medicine Department, Faculty of Medicine, Universidad Complutense de Madrid , Madrid, Spain., Escribano P; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón , Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón , Madrid, Spain.; School of Health Sciences, HM Hospitals, Universidad Camilo José Cela , Madrid, Spain., Guinea J; Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón , Madrid, Spain.; Instituto de Investigación Sanitaria Gregorio Marañón , Madrid, Spain.; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058) , Madrid, Spain.; School of Health Sciences, HM Hospitals, Universidad Camilo José Cela , Madrid, Spain.
Jazyk:	angličtina
Zdroj:	Antimicrobial agents and chemotherapy [Antimicrob Agents Chemother] 2023 Nov 15; Vol. 67 (11), pp. e0098623. Date of Electronic Publication: 2023 Oct 18.
DOI:	10.1128/aac.00986-23
Abstrakt:	We previously conducted a multicenter surveillance study on Candida epidemiology and antifungal resistance in Madrid (CANDIMAD study; 2019-2021), detecting an increase in fluconazole-resistant Candida parapsilosis . We here present data on isolates collected in 2022. Furthermore, we report the epidemiology and antifungal resistance trends during the entire period, including an analysis per ward of admission. Candida spp. incident isolates from blood cultures and intra-abdominal samples from patients cared for at 16 hospitals in Madrid, Spain, were tested with the EUCAST E.Def 7.3.2 method against amphotericin B, azoles, micafungin, anidulafungin, and ibrexafungerp and were molecularly characterized. In 2022, we collected 766 Candida sp. isolates (686 patients; blood cultures, 48.8%). Candida albicans was the most common species found, and Candida auris was undetected. No resistance to amphotericin B was found. Overall, resistance to echinocandins was low (0.7%), whereas fluconazole resistance was 12.0%, being higher in blood cultures (16.0%) mainly due to fluconazole-resistant C. parapsilosis clones harboring the Y132F-R398I ERG11p substitutions. Ibrexafungerp showed in vitro activity against the isolates tested. Whereas C. albicans was the dominant species in most hospital wards, we observed increasing C. parapsilosis proportions in blood. During the entire period, echinocandin resistance rates remained steadily low, while fluconazole resistance increased in blood from 6.8% (2019) to 16% (2022), mainly due to fluconazole-resistant C. parapsilosis (2.6% in 2019 to 36.6% in 2022). Up to 7 out of 16 hospitals were affected by fluconazole-resistant C. parapsilosis . In conclusion, rampant clonal spreading of C. parapsilosis fluconazole-resistant genotypes is taking place in Madrid. Competing Interests: J.G. has received funds for participating in educational activities organized on behalf of Gilead, Pfizer, Mundipharma, and MSD; he has also received research funds from FIS, Gilead, Scynexis, F2G, Mundipharma, and Cidara, outside the submitted work.
Databáze:	MEDLINE
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