Distribution, virulence attributes and antifungal susceptibility patterns ofCandida parapsilosiscomplex strains isolated from clinical samples

Abstract

It was recently proposed that Candida parapsilosis represents a complex composed of three closely related species, i.e., C. parapsilosis sensu stricto, C. orthopsilosis, and C. metapsilosis. The aim of this study was to describe the distribution of C. parapsilosis complex isolates among clinical samples. We also evaluated antifungal susceptibility profiles, in vitro presence of lipase and secreted aspartyl proteinase, as well as their ability to grow in total parenteral nutrition (TPN) solution, and biofilm production. A total of 413 non-C. albicans Candida isolates were obtained from various clinical samples between 2010 and 2011 in a Turkish Tertiary Care Hospital. Of them, 42 were identified as members of the C. parapsilosis complex. Among these, 38 (90.5%) were C. parapsilosis sensu stricto, 3 (7.1%) C. metapsilosis, and 1 (2.4%) C. orthopsilosis. All isolates recovered from blood were found to be C. parapsilosis sensu stricto and C. metapsilosis. In phenotypic tests, all 42 isolates grew in TPN solution and, although 26.2% of C. parapsilosis sensu stricto-isolates were capable of forming biofilms in vitro, neither C. orthopsilosis nor C. metapsilosis isolates were able to do so. Acid proteinase activity was detected in 31% of isolates and lipase activity in 33%. All isolates were sensitive to voriconazole, caspofungin, and anidulafungin, with only a single C. parapsilosis sensu stricto isolate showing dose-dependent susceptible to fluconazole. While the number of C. metapsilosis and C. orthopsilosis isolates remained low, there were no significant differences in antifungal MIC as compared to C. parapsilosis sensu stricto.

Identification to Species Level of Candida parapsilosis Complex into Sites Oral Cavity in a Cohort of Argentinos Patients

“…This result is similar to that reported by other authors as Ghanoun et al [4]; Enger et al [11]; Silva et al [8]; Ge et al [10]; and Tosun et al [9] (Table 6). …”

“…So far it is known that C. parapsilosis sensu stricto is the most prevalent species in oral niche in conditions of immune-competence, regardless of geographic region. This has been reported studies from USA [4], Portugal [8], Turkey [9] and China [10]. While a single work in Brazil, investigated the distribution of species of this complex in oral cavity of chronic immunocompromised patients for HIV, in which C. methapsilosis was the most isolated species followed by C. parapsilosis sensu stricto, although the difference it was not statistically significant, and also the sample used was very escasa [2].…”

The Oral Cavity: A Reservoir that Favors Colonization and Selection of Candida parapsilosis sensu stricto Strains with High Pathogen Potential Under Conditions of Gingival-periodontal Disease

“…In this complex, C. parapsilosis sensu stricto is the species most frequently recovered from clinical isolates of immunocompetent and immunocompromised patients, both in normal and pathological conditions [7,[41][42][43][44][45][46][47]. This knowledge has been supported by many studies around the world.…”

Molecular Characterization of Candida parapsilosis Species Complex in Niches of the Oral Cavity in a Cohort of Patients from Argentina with Different Oral and Dental Clinical Manifestations

“…The few published works on the subject report varying results on the distribution of the complex in this specific ecological niche, emphasizing that C parapsilosis sensu stricto is the species mostly recovered in immunocompetent individuals either in Europe or in North America [3,7,8], while C. methapsilosis might apparently predominate over C. parapsilosis sensu stricto in immunocompromised patients. Evidence of this is the result of the study presented by Moris DV et al, who found in oral cavity of patients with HIV, a total prevalence of 4.7%with 2.2% of C. parapsilosis sensu estrico and 2.5% of C. methapsilosis, but did not find the presence of C. orthopsilosis [9].…”

“…Variability in antifungal susceptibility profiles has been reported among species of this complex [10], besides the decreased susceptibility of C. parapsilosis sensu stricto to azoles and echinocandins [3,7,10,11]. The development and subsequent expansion of nosocomial C. parapsilosis resistant to these drugs have major clinical implications.…”