Multilocus Sequence Typing and Antifungal Susceptibility of Vaginal and Non-vaginal Candida glabrata Isolates From China

Abstract

Candida glabrata is a common cause of Candida infections. In our present study, we investigated the antifungal susceptibility and molecular epidemiology of vaginal and non-vaginal C. glabrata isolates. Seventy-six vaginal C. glabrata strains isolated from patients with vulvovaginal candidiasis and 57 non-vaginal C. glabrata isolates were collected at two hospitals in Shanghai, China. Antifungal susceptibility was examined using a broth microdilution method. Multilocus sequence typing was used for genotyping. Overall, 28 (21.1%), 28 (21.1%), and 29 (21.8%) C. glabrata isolates were resistant to fluconazole, itraconazole, and voriconazole, respectively. Briefly, 18 (23.7%), 18 (23.7%), and 19 (25%) vaginal strains were resistant to fluconazole, itraconazole, and voriconazole. While the resistance to these antifungals were all 17.5% (10/57) in non-vaginal strains. All isolates retained susceptibility to amphotericin B, and only four non-vaginal isolates were caspofungin resistant. Genotyping identified 17 ST patterns. In non-vaginal samples, the same genotypes appear as in the vaginal samples, except for one genotype (ST-182), while in the vaginal samples more genotypes appear (ST8, ST19, ST45, ST55, ST66, ST80, ST138, and ST17). The most common genotype was ST7 (81 strains), followed by ST10 (14 strains) and ST15 (11 strains). The majority of resistant phenotype strains (25/30, 83.3%) correlated to the predominant genotype (ST7), and the rest belonged to ST3 (2/30, 6.7%), ST10 (1/30, 3.3%), ST19 (1/30, 3.3%), and ST45 (1/30, 3.3%). Our survey revealed cross-resistance in vaginal and non-vaginal C. glabrata isolates. Moreover, there is no genotype associated with the resistance phenotype.

Molecular fingerprinting by multi-locus sequence typing identifies microevolution and nosocomial transmission of Candida glabrata in Kuwait

“…isolates have mostly been carried out by employing MLST or MLMT-based methods (28-31, 34, 41-43). Although MLST schemes were devised for C. albicans (44) and C. glabrata (26) at nearly the same time, extensive studies have been carried out on clinical C. albicans isolates while only few studies have explored the population structure of C. glabrata (28,31,(45)(46)(47)(48)(49)(50)(51)(52)(53).…”

“…C. glabrata is among the most frequently isolated NACS from clinical specimens in Kuwait (17,18) (53) from China. The higher genetic diversity of C. glabrata from Kuwait, an Arabian Gulf country much smaller than Australia, Iran or Tanzania, is likely due to the large (nearly three times of Kuwaiti nationals) and highly diverse expatriate population (54,55).…”

Importance of Candida infection and fluconazole resistance in women with vaginal discharge syndrome in Namibia

“…In our study, like most other studies looking at the species distribution of Candida , the most prevalent Candida species isolated was C. albicans , followed by C. glabrata [ 47 , 48 ]. Candida glabrata is the most relevant non-albicans Candida species, owing to its ability to develop acquired resistance subsequent to exposure to azole antifungals [ 11 , 12 , 49 ]. In our study, low rate of fluconazole resistance was found in C. albicans isolates (< 5%), but most non-albicans Candida isolates ( n = 19, 17%) were fluconazole resistant.…”

“…Non-albicans Candida species have emerged as an important aetiology of VVC as its prevalence and antifungal resistance is a mounting problem globally [ 10 , 11 ]. The most significant of these non-albicans Candida species is Candida glabrata owing to its intrinsic resistance or low susceptibility to azoles [ 12 ]. Other than C. glabrata , C. krusei, C. tropicalis, C. parapsilosis and, very rarely, Saccharomyces cerevisiae , are other potential pathogens that may lead to VVC [ 13 ].…”

Population genomic analyses reveal high diversity, recombination and nosocomial transmission among Candida glabrata (Nakaseomyces glabrata) isolates causing invasive infections

“…[18,19]). However, since 2003, multilocus sequence typing (MLST) has been the main method for genotyping and for investigating the spatial and temporal patterns of genetic variation in C. glabrata [20][21][22][23][24]. These studies have revealed contrasting patterns, such as low genetic relatedness in isolates recovered from the same geographical region as well as highly similar genotypes among distant locations.…”