Article ; Online: Clonal spread of fluconazole-resistant C. parapsilosis in patients admitted to a referral hospital located in Burgos, Spain, during the COVID-19 pandemic.
2024 Volume 67, Issue 1, Page(s) e13685
Abstract: Background: Fluconazole-resistant Candida parapsilosis (FRCP) is a matter of concern in Spain.: Objectives: We here report a FRCP spread across a 777-bed referral hospital located in Burgos, Spain, during the COVID-19 pandemic.: Patients/methods: ... ...
| Abstract | Background: Fluconazole-resistant Candida parapsilosis (FRCP) is a matter of concern in Spain. Objectives: We here report a FRCP spread across a 777-bed referral hospital located in Burgos, Spain, during the COVID-19 pandemic. Patients/methods: In April 2021, an FRCP isolate (MIC = 64 mg/L, E-test®) from a hospitalised patient was detected. Up to June 2022, all C. parapsilosis isolates (n = 35) from hospitalised patients (n = 32) were stored and genotyped using microsatellite markers, and their antifungal susceptibilities were studied (EUCAST); FRCP isolates were molecularly characterised. Results: We detected 26 FRCP isolates collected between 2021 (n = 8) and 2022 (n = 18); isolates were susceptible to amphotericin B, echinocandins and ibrexafungerp. FRCP isolates were grouped into three genotypes: CP-707 and CP-708 involved isolates harbouring the Y132F + R398I ERG11p substitutions (n = 24) and were clonally related; the remaining CP-675 genotype involved isolates harbouring the G458S ERG11p substitution (n = 2). FRCP genotypes were genetically related to the FRCP genotypes found in Madrid and were unrelated to fluconazole-susceptible ones. Patients harbouring FRCP were mainly (n = 22/23) admitted to intensive care units. Most patients had received broad-spectrum antibiotics (n = 22/23), and/or antifungal therapy with azoles (n = 14/23) within the 30 days prior to FRCP isolation. Thirteen patients were colonised, 10 of whom were infected and presented candidaemia (n = 8/10), endovascular infection (n = 1/10) or complicated urinary infection (n = 1/10). Overall nonattributable 30-day mortality was 17% (n = 4/23). Conclusions: We report an outbreak caused by FRCP affecting patients admitted to the ICU of a referral hospital located in Burgos. Patients harbouring FRCP had a higher fluconazole use than those carrying susceptible isolates. |
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| MeSH term(s) | Humans ; Fluconazole/pharmacology ; Fluconazole/therapeutic use ; Antifungal Agents/pharmacology ; Antifungal Agents/therapeutic use ; Candida parapsilosis ; Spain/epidemiology ; Pandemics ; Microbial Sensitivity Tests ; Drug Resistance, Fungal/genetics ; COVID-19/epidemiology ; Hospitals ; Referral and Consultation |
| Chemical Substances | Fluconazole (8VZV102JFY) ; Antifungal Agents |
| Language | English |
| Publishing date | 2024-01-28 |
| Publishing country | Germany |
| Document type | Journal Article |
| ZDB-ID | 392487-7 |
| ISSN | 1439-0507 ; 0933-7407 |
| ISSN (online) | 1439-0507 |
| ISSN | 0933-7407 |
| DOI | 10.1111/myc.13685 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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