Monitoring the Epidemiology and Antifungal Resistance of Yeasts Causing Fungemia in a Tertiary Care Hospital in Madrid, Spain: Any Relevant Changes in the Last 13 Years?

We conducted an updated analysis on yeast isolates causing fungemia in patients admitted to a tertiary hospital in Madrid, Spain, over a 13-year period. We studied 896 isolates associated with 872 episodes of fungemia in 857 hospitalized patients between January 2007 and December 2019. Antifungal su...

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Detalles Bibliográficos
Autores: Diaz-Garcia, Judith, Mesquida, Aina, Sanchez-Carrillo, Carlos, Reigadas, Elena, Muñoz, Patricia, Escribano, Pilar, Guinea, Jesús
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad Camilo José Cela (UCJC)
Repositorio:Depósito Digital e-UCJC
OAI Identifier:oai:repositorio.ucjc.edu:20.500.12020/1813
Acceso en línea:http://hdl.handle.net/20.500.12020/1813
https://doi.org/10.1128/aac.01827-20
Access Level:acceso abierto
Palabra clave:Ciencias Biomédicas
Fungemia
Yeast
Candida
EUCAST
Microsatellite genotyping
Antifungal resistance
Fluconazole
Resistance
2414 Microbiología
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spelling Monitoring the Epidemiology and Antifungal Resistance of Yeasts Causing Fungemia in a Tertiary Care Hospital in Madrid, Spain: Any Relevant Changes in the Last 13 Years?Diaz-Garcia, JudithMesquida, AinaSanchez-Carrillo, CarlosReigadas, ElenaMuñoz, PatriciaEscribano, PilarGuinea, JesúsCiencias BiomédicasFungemiaYeastCandidaEUCASTMicrosatellite genotypingAntifungal resistanceFluconazoleResistance2414 MicrobiologíaWe conducted an updated analysis on yeast isolates causing fungemia in patients admitted to a tertiary hospital in Madrid, Spain, over a 13-year period. We studied 896 isolates associated with 872 episodes of fungemia in 857 hospitalized patients between January 2007 and December 2019. Antifungal susceptibility was assessed by EUCAST EDef 7.3.2. Mutations conferring azole and echinocandin resistance were further studied, and genotyping of resistant clones was performed with species-specific microsatellite markers. Candida albicans (45.8%) was the most frequently identified species, followed by the Candida parapsilosis complex (26.4%), Candida glabrata (12.3%), Candida tropicalis (7.3%), Candida krusei (2.3%), other Candida spp. (3.1%), and non-Candida yeasts (2.8%). The rate of fluconazole resistance in Candida spp. was 4.7%, ranging from 0% (C. parapsilosis) to 9.1% (C. glabrata). The overall rate of echinocandin resistance was 3.1%. Resistance was highly influenced by the presence of intrinsically resistant species. Although the number of isolates between 2007 and 2013 was almost 2-fold higher than that in the period from 2014 to 2019 (566 versus 330), fluconazole resistance in Candida spp. was greater in the second period (3.5% versus 6.8%; P,0.05), while overall resistance to echinocandins remained stable (3.5% versus 2.4%; P.0.05). Resistant clones were collected from different wards and/or time points, suggesting that there were no epidemiological links. The number of fungemia episodes has been decreasing over the last 13 years, with a slight increase in the rate of fluconazole resistance and stable echinocandin resistance. Antifungal resistance is not the cause of the spread of resistant clones.American Society for Clinical Microbiology2021info:eu-repo/semantics/articlehttp://hdl.handle.net/20.500.12020/1813https://doi.org/10.1128/aac.01827-20reponame:Depósito Digital e-UCJCinstname:Universidad Camilo José Cela (UCJC)Inglésinfo:eu-repo/semantics/openAccessoai:repositorio.ucjc.edu:20.500.12020/18132026-05-27T07:36:51Z
dc.title.none.fl_str_mv Monitoring the Epidemiology and Antifungal Resistance of Yeasts Causing Fungemia in a Tertiary Care Hospital in Madrid, Spain: Any Relevant Changes in the Last 13 Years?
title Monitoring the Epidemiology and Antifungal Resistance of Yeasts Causing Fungemia in a Tertiary Care Hospital in Madrid, Spain: Any Relevant Changes in the Last 13 Years?
spellingShingle Monitoring the Epidemiology and Antifungal Resistance of Yeasts Causing Fungemia in a Tertiary Care Hospital in Madrid, Spain: Any Relevant Changes in the Last 13 Years?
Diaz-Garcia, Judith
Ciencias Biomédicas
Fungemia
Yeast
Candida
EUCAST
Microsatellite genotyping
Antifungal resistance
Fluconazole
Resistance
2414 Microbiología
title_short Monitoring the Epidemiology and Antifungal Resistance of Yeasts Causing Fungemia in a Tertiary Care Hospital in Madrid, Spain: Any Relevant Changes in the Last 13 Years?
title_full Monitoring the Epidemiology and Antifungal Resistance of Yeasts Causing Fungemia in a Tertiary Care Hospital in Madrid, Spain: Any Relevant Changes in the Last 13 Years?
title_fullStr Monitoring the Epidemiology and Antifungal Resistance of Yeasts Causing Fungemia in a Tertiary Care Hospital in Madrid, Spain: Any Relevant Changes in the Last 13 Years?
title_full_unstemmed Monitoring the Epidemiology and Antifungal Resistance of Yeasts Causing Fungemia in a Tertiary Care Hospital in Madrid, Spain: Any Relevant Changes in the Last 13 Years?
title_sort Monitoring the Epidemiology and Antifungal Resistance of Yeasts Causing Fungemia in a Tertiary Care Hospital in Madrid, Spain: Any Relevant Changes in the Last 13 Years?
dc.creator.none.fl_str_mv Diaz-Garcia, Judith
Mesquida, Aina
Sanchez-Carrillo, Carlos
Reigadas, Elena
Muñoz, Patricia
Escribano, Pilar
Guinea, Jesús
author Diaz-Garcia, Judith
author_facet Diaz-Garcia, Judith
Mesquida, Aina
Sanchez-Carrillo, Carlos
Reigadas, Elena
Muñoz, Patricia
Escribano, Pilar
Guinea, Jesús
author_role author
author2 Mesquida, Aina
Sanchez-Carrillo, Carlos
Reigadas, Elena
Muñoz, Patricia
Escribano, Pilar
Guinea, Jesús
author2_role author
author
author
author
author
author
dc.subject.none.fl_str_mv Ciencias Biomédicas
Fungemia
Yeast
Candida
EUCAST
Microsatellite genotyping
Antifungal resistance
Fluconazole
Resistance
2414 Microbiología
topic Ciencias Biomédicas
Fungemia
Yeast
Candida
EUCAST
Microsatellite genotyping
Antifungal resistance
Fluconazole
Resistance
2414 Microbiología
description We conducted an updated analysis on yeast isolates causing fungemia in patients admitted to a tertiary hospital in Madrid, Spain, over a 13-year period. We studied 896 isolates associated with 872 episodes of fungemia in 857 hospitalized patients between January 2007 and December 2019. Antifungal susceptibility was assessed by EUCAST EDef 7.3.2. Mutations conferring azole and echinocandin resistance were further studied, and genotyping of resistant clones was performed with species-specific microsatellite markers. Candida albicans (45.8%) was the most frequently identified species, followed by the Candida parapsilosis complex (26.4%), Candida glabrata (12.3%), Candida tropicalis (7.3%), Candida krusei (2.3%), other Candida spp. (3.1%), and non-Candida yeasts (2.8%). The rate of fluconazole resistance in Candida spp. was 4.7%, ranging from 0% (C. parapsilosis) to 9.1% (C. glabrata). The overall rate of echinocandin resistance was 3.1%. Resistance was highly influenced by the presence of intrinsically resistant species. Although the number of isolates between 2007 and 2013 was almost 2-fold higher than that in the period from 2014 to 2019 (566 versus 330), fluconazole resistance in Candida spp. was greater in the second period (3.5% versus 6.8%; P,0.05), while overall resistance to echinocandins remained stable (3.5% versus 2.4%; P.0.05). Resistant clones were collected from different wards and/or time points, suggesting that there were no epidemiological links. The number of fungemia episodes has been decreasing over the last 13 years, with a slight increase in the rate of fluconazole resistance and stable echinocandin resistance. Antifungal resistance is not the cause of the spread of resistant clones.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/20.500.12020/1813
https://doi.org/10.1128/aac.01827-20
url http://hdl.handle.net/20.500.12020/1813
https://doi.org/10.1128/aac.01827-20
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv American Society for Clinical Microbiology
publisher.none.fl_str_mv American Society for Clinical Microbiology
dc.source.none.fl_str_mv reponame:Depósito Digital e-UCJC
instname:Universidad Camilo José Cela (UCJC)
instname_str Universidad Camilo José Cela (UCJC)
reponame_str Depósito Digital e-UCJC
collection Depósito Digital e-UCJC
repository.name.fl_str_mv
repository.mail.fl_str_mv
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