Candida Genotyping of Blood Culture Isolates from Patients Admitted to 16 Hospitals in Madrid: Genotype Spreading during the COVID-19 Pandemic Driven by Fluconazole-Resistant C. parapsilosis

Abstract

Background: Candidaemia and invasive candidiasis are typically hospital-acquired. Genotyping isolates from patients admitted to different hospitals may be helpful in tracking clones spreading across hospitals, especially those showing antifungal resistance. Methods: We characterized Candida clusters by studying Candida isolates (C. albicans, n = 1041; C. parapsilosis, n = 354, and C. tropicalis, n = 125) from blood cultures (53.8%) and intra-abdominal samples (46.2%) collected as part of the CANDIMAD (Candida in Madrid) study in Madrid (2019–2021). Species-specific microsatellite markers were used to define the genotypes of Candida spp. found in a single patient (singleton) or several patients (cluster) from a single hospital (intra-hospital cluster) or different hospitals (widespread cluster). Results: We found 83 clusters, of which 20 were intra-hospital, 49 were widespread, and 14 were intra-hospital and widespread. Some intra-hospital clusters were first detected before the onset of the COVID-19 pandemic, but the number of clusters increased during the pandemic, especially for C. parapsilosis. The proportion of widespread clusters was significantly higher for genotypes found in both compartments than those exclusively found in either the blood cultures or intra-abdominal samples. Most C. albicans- and C. tropicalis-resistant genotypes were singleton and presented exclusively in either blood cultures or intra-abdominal samples. Fluconazole-resistant C. parapsilosis isolates belonged to intra-hospital clusters harboring either the Y132F or G458S ERG11p substitutions; the dominant genotype was also widespread. Conclusions: the number of clusters—and patients involved—increased during the COVID-19 pandemic mainly due to the emergence of fluconazole-resistant C. parapsilosis genotypes.

Clonal spread of fluconazole‐resistant C. parapsilosis in patients admitted to a referral hospital located in Burgos, Spain, during the COVID‐19 pandemic

“…FRCP causes difficult‐to‐manage hospital outbreaks 5 . Recent reports alerted to an increase in the number of hospitals affected by FRCP in Spain 8 ; up to seven hospitals in the Madrid area are currently affected 9–11,15 . The outset of the outbreak reported herein is unknown; however, the isolates are genotypically related to those found in Madrid, suggesting some kind of epidemiological relationship between affected hospitals.…”

“…655180; Greiner bio-one, Frickenhausen, Germany). 10 Isolates were categorised as resistant and/or non-wild type. 12,13…”

“…8 Isolates harbouring the G458S substitution were recently detected in a hospital located in Madrid in late 2021. [9][10][11] Phenotypic FRCP was detected for the first time in April 2021, in patients admitted to a referral hospital in Burgos, a city located in Northern Spain. We here report the spread of such isolates across the hospital and describe a new outbreak caused by FCRP isolates in a hospital in Spain.…”

“…These isolates mostly harbour the Y132F ERG11p substitution, 5 which was first detected in Spain in Palma de Mallorca in 2019 6 and later on in Madrid, 7 Santander and Barcelona 8 . Isolates harbouring the G458S substitution were recently detected in a hospital located in Madrid in late 2021 9–11 …”

Correction: Díaz-García et al. Candida Genotyping of Blood Culture Isolates from Patients Admitted to 16 Hospitals in Madrid: Genotype Spreading during the COVID-19 Pandemic Driven by Fluconazole-Resistant C. parapsilosis. J. Fungi 2022, 8, 1228

“…In the original publication [ 1 ], a format error in Figure 2 was detected. A correction has been made to Figure 2 in the Results section, Section 3.1.…”