Prevalence and Susceptibility Profile of Candida metapsilosis and Candida orthopsilosis : Results from Population-Based Surveillance of Candidemia in Spain

Abstract

We describe the prevalences and susceptibility profiles of two recently described species, Candida metapsilosis and Candida orthopsilosis, related to Candida parapsilosis in candidemia. The prevalences of these species (1.7% for C. metapsilosis and 1.4% for C. orthopsilosis) are significant. Differences observed in their susceptibility profiles could have therapeutic importance.

Prevalence and antifungal susceptibility of Candida parapsilosis complex isolates collected from oral cavities of HIV-infected individuals

“…C. metapsilosis isolates displayed a tendency to have diminished susceptibility to FLC, compared with C. parapsilosis sensu stricto with median MICs of 1.5 and 0.5 mg ml 21 , respectively, which are agreement with those observed by van Asbeck et al (1995) and Hensgens et al (2009), showing all isolates to be susceptible to this antifungal compound. Several authors reported sensitivity of C. parapsilosis complex isolates to ITC (Gomez-Lopez et al, 2008;Gonçalves et al, 2010;Kocsubé et al, 2007), which was also noted in our study; this was not the case for one out of four C. metapsilosis isolates, which showed a dose-dependant susceptibility (DDS) to this azole compound, as reported by Gonçalves et al (2010). The majority of the isolates were susceptible to VRC in the present study, which was also found in other studies ( (2008) also observed that higher MICs of CASPO were detected for C. parapsilosis sensu stricto than for C. metapsilosis.…”

“…Sensitivity to AMB was confirmed in previous studies from MICs ¡1 mg ml 21 (Lin et al, 1995;Gomez-Lopez et al, 2008;Gonçalves et al, 2010;Kocsubé et al, 2007). It is of note that Silva et al (2009) reported two cases out of 160 isolates of C. parapsilosis sensu stricto that developed resistance to AMB and Lockhart et al (2008) reported that the MICs of AMB for C. metapsilosis were lower than those of C. parapsilosis sensu stricto.…”

“…It was also suggested that C. orthopsilosis and C. metapsilosis might be more susceptible to amphotericin B (AMB) and echinocandins than C. parapsilosis sensu stricto (Gomez-Lopez et al, 2008;van Asbeck et al, 2008;Garcia-Effron et al, 2008) and that these differences in antifungal susceptibility could affect choice of therapy. It is, therefore, important to determine the distribution of these species in our environment, particularly in HIV-infected individuals, and to correlate genotypic variation in these species with virulence capabilities, as well as susceptibility to antifungal drugs.…”

“…Although the C. parapsilosis complex has been recognized as comprising distinct species, little is known about the transmission and infectivity of the two more rare species present within the complex, C. orthopsilosis and C. metapsilosis, while C. parapsilosis has now been recognized as a major human fungal pathogen, ranking as the second or third most frequently occurring cause of bloodstream infection in Europe, Canada and Latin America (Almirante et al, 2006;Pemán et al, 2005;Pfaller et al, 2008). Data on the frequency of isolation of C. orthopsilosis and C. metapsilosis have just started to be released (Odds et al, 2007;Tavanti et al, 2007;Kocsubé et al, 2007;Gomez-Lopez et al, 2008;Lockhart et al, 2008;Hensgens et al, 2009;Silva et al, 2009;Gonçalves et al, 2010;Ghannoum et al, 2010;Bonfietti et al, 2012). These retrospective epidemiological studies have been undertaken to screen for C. orthopsilosis and C. metapsilosis among isolates previously identified as C. parapsilosis, showing that a small proportion of isolates actually belong to the species C. orthopsilosis or C. metapsilosis, with significant geographical variation.…”

Molecular identification and antifungal susceptibility profiles of Candida parapsilosis complex species isolated from culture collection of clinical samples

“…Similarly, FLC resistance in C. metapsilosis and C. parapsilosis sensu stricto has been observed by Chen et al (40) Moreover, Gomez-Lopez et al (41) found an MIC of greater than 4µg/mL FLC for these species, while Silva et al (6) found an MIC of 16µg/mL FLC for one C. parapsilosis sensu stricto isolate. According to Van Asbeck et al (42) , the differences in FLC susceptibility may also refl ect the different affi nities of azoles for the key ergosterol-synthesizing enzyme 14-α-demethylase or for other enzymes in this pathway.…”