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Cited by 33Antifungal resistance and susceptibilityYeasts and Rust Fungi StudiesFungal and yeast genetics research

Multilocus sequence typing of sequential Candida albicans isolates from patients with persistent or recurrent fungemia

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Da Matta, Daniel A., Melo, Analy S., Guimarães, Thaís, Frade, João P., Lott, Timothy J., Colombo, Arnaldo L.·2010·Medical Mycology
DOI 10.3109/13693780903501689
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Abstract

Multilocus sequence typing (MLST) is a useful tool to explore the phylogenetics and epidemiology of Candida albicans isolates recovered from cases of invasive candidiasis. The goal of this study was to determine whether the same or different strains were responsible for persistent or recurrent fungemia through the use of MLST and ABC typing on sequential C. albicans isolates from the same patient. We applied both typing methods to 21 C. albicans strains recovered from 8 patients with persistent or recurrent candidemia. The isolates were collected during a multicenter surveillance study in four public tertiary care hospitals in Brazil. Persistent candidemia was defined as two or more blood cultures positive for C. albicans on 2 or more separate days. Recurrent candidemia was defined as an episode of candidemia occurring at least 1 month after the apparent complete resolution of an infectious episode caused by Candida species. We observed that, except for one patient, all strains from the first and second samples of the same patient showed the same MLST diploid sequence type (DST), ABC type and susceptibility profile to antifungals. Three distinct strains, well discriminated by MLST, were found in the seven samples collected sequentially over 10 days from one patient. The strains from the first four samples were indistinguishable, the fifth and sixth were also indistinguishable but different from the first four and seventh samples. Significantly, the seventh strain was the only C. albicans clade 2 isolate found in our total collection involving 61 patients, although clade 2 is commonly found worldwide. To the best of our knowledge, this is the first study describing the recovery of three distinct C. albicans strains in the same patient with a persistent blood stream infection within a short period of time.

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  • Organisms that cause persistent infections have similar susceptibilities to organisms that are readily cleared by a course of antifungal treatment.

    “In effect, organisms that cause persistent infections, defined as those that are not cleared by a course of antifungal treatment, have similar susceptibilities to organisms that are readily cleared by a course of antifungal treatment 7 .”

    From Antifungal tolerance is a subpopulation effect distinct from resistance and is associated with persistent candidemia (2018) · cites this paper as [7]

    The Results (p. 4) report that C. albicans isolates from patients with persistent or recurrent candidemia remained susceptible to the three antifungals tested. The paper does not compare those isolates with organisms readily cleared by treatment; it also defines persistent candidemia by repeated positive blood cultures, not by failure to clear after a course of treatment (p. 1). (LLM, conf=0.88)

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  • Persistent candidemia is associated with increased mortality.

    “Persistent candidemia, defined as the failure to clear a bloodstream infection caused by a susceptible organism 7,16 , is associated with increased mortality.”

    From Antifungal tolerance is a subpopulation effect distinct from resistance and is associated with persistent candidemia (2018) · cites this paper as [7]

    The Introduction (p. 1) says Candida bloodstream infections are associated with significant mortality. The paper studies persistent candidemia, but the passages do not say that persistence is associated with increased mortality compared with nonpersistent infection. (LLM, conf=0.83)

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Authors
Da Matta, D. A., Melo, A. S., Guimarães, T., Frade, J. P., Lott, T. J., & Colombo, A. L.
Affiliations
  • Universidade Federal de São Paulo (BR)
  • Hospital do Servidor Público Estadual (BR)
  • Centers for Disease Control and Prevention (US)
Corresponding author
Colombo, Arnaldo L.
ORCID
Venue
Medical Mycology
Publisher
Oxford University Press (OUP)
Published
2010-08
Volume
48
Issue
5
Pages
757-762
ISSN
  • 0268-1218 (ISSN-L)
  • 1369-3786
  • 1460-2709
DOI
10.3109/13693780903501689
OpenAlex
W2138353693
Cited by
33
References
27
Citations by year
2025: 1 · 2024: 2 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 4 · 2017: 4 · 2015: 4 · 2014: 4 · 2013: 4 · 2012: 1
FWCI
1.45
Type
journal article
Language
en
Open access
Locations
  • Medical Mycology (publishedVersion)
  • PubMed (publishedVersion)
  • Americanae (AECID Library) (publishedVersion)
  • HighWire Press Open Archive (submittedVersion)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
Funders
  • Conselho Nacional de Desenvolvimento Científico e Tecnológico
  • Centers for Disease Control and Prevention
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Yeasts and Rust Fungi Studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Fungal and yeast genetics research
Keywords
Candida albicans, persistent candidemia, multilocus sequence typing, antifungal susceptibility, invasive candidiasis, bloodstream infection, strain differentiation, molecular epidemiology
MeSH terms
Brazil, Candida albicans, Candidiasis, DNA, Fungal, Genotype, Hospitals, Humans, Recurrence, DNA Fingerprinting, Fungemia, Mycological Typing Techniques, Sequence Analysis, DNA, Molecular Epidemiology

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