Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates

Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates Publisher Pubmed

Arastehfar A¹ ; Daneshnia F¹ ; Najafzadeh MJ² ; Hagen F^{1, 3, 4} ; Mahmoudi S⁵ ; Salehi M⁶ ; Zarrinfar H⁷ ; Namvar Z⁸ ; Zareshahrabadi Z⁹ ; Khodavaisy S¹⁰ ; Zomorodian K⁹ ; Pan W¹¹ ; Theelen B¹ ; Kostrzewa M¹² Show All Authors

Arastehfar A¹
Daneshnia F¹
Najafzadeh MJ²
Hagen F^{1, 3, 4}
Mahmoudi S⁵
Salehi M⁶
Zarrinfar H⁷
Namvar Z⁸
Zareshahrabadi Z⁹
Khodavaisy S¹⁰
Zomorodian K⁹
Pan W¹¹
Theelen B¹
Kostrzewa M¹²
Boekhout T^{1, 13}
Lassflorl C¹⁴

Source: Frontiers in Cellular and Infection Microbiology Published:2020

Abstract

Clonal expansion of fluconazole resistant (FLZ-R) Candida parapsilosis isolates is increasingly being identified in many countries, while there is no study exploring the antifungal susceptibility pattern, genetic diversity, and clinical information for Iranian C. parapsilosis blood isolates. Candida parapsilosis species complex blood isolates (n = 98) were recovered from nine hospitals located in three major cities, identified by MALDI-TOF MS, and their genetic relatedness was examined by AFLP fingerprinting. Antifungal susceptibility testing followed CLSI-M27-A3 and ERG11, MRR1 and hotspots 1/2 (HS1/2) of FKS1 were sequenced to assess the azole and echinocandin resistance mechanisms, respectively. Ninety-four C. parapsilosis and four Candida orthopsilosis isolates were identified from 90 patients. Only 43 patients received systemic antifungal drugs with fluconazole as the main antifungal used. The overall mortality rate was 46.6% (42/90) and death mostly occurred for those receiving systemic antifungals (25/43) relative to those not treated (17/47). Although, antifungal-resistance was rare, one isolate was multidrug-resistant (FLZ = 16 μg/ml and micafungin = 8 μg/ml) and the infected patient showed therapeutic failure to FLZ prophylaxis. Mutations causing azole and echinocandin resistance were not found in the genes studied. AFLP revealed five genotypes (G) and G1 was the main one (59/94; 62.7%). Clinical outcome was significantly associated with city (P = 0.02, α <0.05) and Mashhad was significantly associated with mortality (P = 0.03, α <0.05). Overall, we found a low level of antifungal resistance for Iranian C. parapsilosis blood isolates, but the noted MDR strain can potentially become the source of future infections and challenge the antifungal therapy in antifungal-naive patients. AFLP typing results warrants confirmation using other resolutive typing methods. © Copyright © 2020 Arastehfar, Daneshnia, Najafzadeh, Hagen, Mahmoudi, Salehi, Zarrinfar, Namvar, Zareshahrabadi, Khodavaisy, Zomorodian, Pan, Theelen, Kostrzewa, Boekhout and Lass-Florl.

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Sadegh Khodavaisy (10)

Mohammadreza Salehi (9)

Style	Citing Format
MLA	Arastehfar A, et al.. "Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates." Frontiers in Cellular and Infection Microbiology, vol. 10, no. , 2020, pp. -.
APA	Arastehfar A, Daneshnia F, Najafzadeh MJ, Hagen F, Mahmoudi S, Salehi M, Zarrinfar H, Namvar Z, Zareshahrabadi Z, Khodavaisy S, Zomorodian K, Pan W, Theelen B, Kostrzewa M, Boekhout T, Lassflorl C (2020). Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates. Frontiers in Cellular and Infection Microbiology, 10(), -.
Chicago	Arastehfar A, Daneshnia F, Najafzadeh MJ, Hagen F, Mahmoudi S, Salehi M, Zarrinfar H, et al.. "Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates." Frontiers in Cellular and Infection Microbiology 10, no. (2020): -.
Harvard	Arastehfar A et al. (2020) 'Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates', Frontiers in Cellular and Infection Microbiology, 10(), pp. -.
Vancouver	Arastehfar A, Daneshnia F, Najafzadeh MJ, Hagen F, Mahmoudi S, Salehi M, et al.. Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates. Frontiers in Cellular and Infection Microbiology. 2020;10():-.
BibTex	@article{ author = {Arastehfar A and Daneshnia F and Najafzadeh MJ and Hagen F and Mahmoudi S and Salehi M and Zarrinfar H and Namvar Z and Zareshahrabadi Z and Khodavaisy S and Zomorodian K and Pan W and Theelen B and Kostrzewa M and Boekhout T and Lassflorl C}, title = {Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates}, journal = {Frontiers in Cellular and Infection Microbiology}, volume = {10}, number = {}, pages = {-}, year = {2020} }
RIS	TY - JOUR AU - Arastehfar A AU - Daneshnia F AU - Najafzadeh MJ AU - Hagen F AU - Mahmoudi S AU - Salehi M AU - Zarrinfar H AU - Namvar Z AU - Zareshahrabadi Z AU - Khodavaisy S AU - Zomorodian K AU - Pan W AU - Theelen B AU - Kostrzewa M AU - Boekhout T AU - Lassflorl C TI - Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates JO - Frontiers in Cellular and Infection Microbiology VL - 10 IS - SP - EP - PY - 2020 ER -

Style

Citing Format

MLA

Arastehfar A, et al.. "Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates." Frontiers in Cellular and Infection Microbiology, vol. 10, no. , 2020, pp. -.

APA

Arastehfar A, Daneshnia F, Najafzadeh MJ, Hagen F, Mahmoudi S, Salehi M, Zarrinfar H, Namvar Z, Zareshahrabadi Z, Khodavaisy S, Zomorodian K, Pan W, Theelen B, Kostrzewa M, Boekhout T, Lassflorl C (2020). Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates. Frontiers in Cellular and Infection Microbiology, 10(), -.

Chicago

Arastehfar A, Daneshnia F, Najafzadeh MJ, Hagen F, Mahmoudi S, Salehi M, Zarrinfar H, et al.. "Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates." Frontiers in Cellular and Infection Microbiology 10, no. (2020): -.

Harvard

Arastehfar A et al. (2020) 'Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates', Frontiers in Cellular and Infection Microbiology, 10(), pp. -.

Vancouver

Arastehfar A, Daneshnia F, Najafzadeh MJ, Hagen F, Mahmoudi S, Salehi M, et al.. Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates. Frontiers in Cellular and Infection Microbiology. 2020;10():-.

BibTex

@article{ author = {Arastehfar A and Daneshnia F and Najafzadeh MJ and Hagen F and Mahmoudi S and Salehi M and Zarrinfar H and Namvar Z and Zareshahrabadi Z and Khodavaisy S and Zomorodian K and Pan W and Theelen B and Kostrzewa M and Boekhout T and Lassflorl C}, title = {Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates}, journal = {Frontiers in Cellular and Infection Microbiology}, volume = {10}, number = {}, pages = {-}, year = {2020} }

RIS

TY - JOUR
AU - Arastehfar A
AU - Daneshnia F
AU - Najafzadeh MJ
AU - Hagen F
AU - Mahmoudi S
AU - Salehi M
AU - Zarrinfar H
AU - Namvar Z
AU - Zareshahrabadi Z
AU - Khodavaisy S
AU - Zomorodian K
AU - Pan W
AU - Theelen B
AU - Kostrzewa M
AU - Boekhout T
AU - Lassflorl C
TI - Evaluation of Molecular Epidemiology, Clinical Characteristics, Antifungal Susceptibility Profiles, and Molecular Mechanisms of Antifungal Resistance of Iranian Candida Parapsilosis Species Complex Blood Isolates
JO - Frontiers in Cellular and Infection Microbiology
VL - 10
IS -
SP -
EP -
PY - 2020
ER -

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