The persistence of multifocal colonisation by a single ABC genotype of Candida albicans may predict the transition from commensalism to infection

Abstract

Candida albicans is a common member of the human microbiota and may cause invasive disease in susceptible populations. Several risk factors have been proposed for candidaemia acquisition. Previous Candida multifocal colonisation among hospitalised patients may be crucial for the successful establishment of candidaemia. Nevertheless, it is still not clear whether the persistence or replacement of a single clone of C. albicans in multiple anatomical sites of the organism may represent an additional risk for candidaemia acquisition. Therefore, we prospectively evaluated the dynamics of the colonising strains of C. albicans for two groups of seven critically ill patients: group I included patients colonised by C. albicans in multiple sites who did not develop candidaemia and group II included patients who were colonised and who developed candidaemia. ABC and microsatellite genotyping of 51 strains of C. albicans revealed that patients who did not develop candidaemia were multiply colonised by at least two ABC genotypes of C. albicans, whereas candidaemic patients had highly related microsatellites and the same ABC genotype in colonising and bloodstream isolates that were probably present in different body sites before the onset of candidaemia

MOLECULAR TYPING OF Candida albicans ISOLATES FROM HOSPITALIZED PATIENTS

“…This result indicates that each isolated pair has genotypic identity, suggesting clonal origin. This fact has been demonstrated by molecular typing, in several studies 10 24 29 37 and helps confirm that previous colonization is an important predisposing factor for systemic infection.…”

“…According to AL-KARAAWI et al 2 , the clinical isolates of C. albicans tend to be genetically similar to each other if they were isolates from patients with a similar profile, as those interned in ICU. CHAVES et al 10 recently showed that candidemic patients had highly related microsatellites genotype in colonizing and bloodstream isolates. However, it should be noted that the detection of yeasts highly similar in our study was not associated with hospital unit.…”

“…by direct or indirect contact and evidence of cross-infection by health care workers, little is known about the origin of clinical isolates of C. albicans . Information on molecular epidemiology has great relevance for the clinical management, treatment and epidemiology of recurrent infections, especially among critically ill patients 10 11 30 . This context led to the proposal of a variety of molecular typing techniques aiming at distinguishing isolates of Candida spp.…”

Candida species distribution, genotyping and virulence factors of Candida albicans isolated from the oral cavity of kidney transplant recipients of two geographic regions of Brazil

“…The majority of other series upon oral candidiasis or oral colonization investigating C. albicans ABC genotypes with the same method have found genotype A as the most prevalent type [9,24,25]. C. albicans Genotype A is also predominant in other series with strains obtained from different body sites, including cases of systemic infection [17,26-29]. …”

Candida albicans: The Ability to Invade Epithelial Cells and Survive under Oxidative Stress Is Unlinked to Hyphal Length

“…C. albicans isolates were obtained from various sources: 997,5 g was isolated from the blood of a deceased patient (Chaves et al, 2012), L3881 (LEMI #L3881, Padovan et al, 2009) was isolated from blood of a patient who had candidemia which was cured clinically, and L3837 was an isolate from the oral cavity (oropharynx, LEMI# L3837, non-hematogenic). C. albicans SC5314 is a reference strain.…”