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Species distribution and susceptibility profile to fluconazole, voriconazole and MXP-4509 of 551 clinical yeast isolates from a Romanian multi-centre study

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Abstract

This is the first multi-centre study regarding yeast infections in Romania. The aim was to determine the aetiological spectrum and susceptibility pattern to fluconazole, voriconazole and the novel compound MXP-4509. The 551 isolates were identified using routine laboratory methods, matrix-assisted laser desorption ionisation time-of-flight mass spectrometry (MALDI-TOF MS) and DNA sequence analysis. Susceptibility testing was performed using the European Committee for Antimicrobial Susceptibility Testing (EUCAST) method and breakpoints. The yeasts originated from superficial infections (SUP, 51.5 %), bloodstream infections (BSI, 31.6 %) and deep-seated infections (DEEP, 16.9 %), from patients of all ages. Nine genera and 30 species were identified. The 20 Candida species accounted for 94.6 % of all isolates. C. albicans was the overall leading pathogen (50.5 %). Lodderomyces elongisporus is reported for the first time as a fungaemia cause in Europe. C. glabrata and Saccharomyces cerevisiae, as well as the non-Candida spp. and non-albicans Candida spp. groups, showed decreased fluconazole susceptibility (<75 %). The overall fluconazole resistance was 10.2 %. C. krusei accounted for 27 of the 56 fluconazole-resistant isolates. The overall voriconazole resistance was 2.5 % and was due mainly to C. glabrata and C. tropicalis isolates. Fluconazole resistance rates for the three categories of infection were similar to the overall value; voriconazole resistance rates differed: 4 % for BSI, 3.2 % for DEEP and 1.4 % for SUP. The antifungal activity of MXP-4509 was superior to voriconazole against C. glabrata and many fluconazole-resistant isolates. There was a large percentage of non-albicans Candida isolates. A large part of the high fluconazole resistance was not acquired but intrinsic, resulting from the high percentage of C. krusei.

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Acknowledgements

This research was financially supported by the Ministry of National Education of Romania - CNCSIS - UEFISCDI, project numbers PN-II-RU-TE-159/2010 “Evaluation of the antifungal effect of nano conjugates of a new propiconazole derivative with beta-cyclodextrin” and PN-II-ID-PCCE-2011-2-0028 “Biologically inspired systems for engineered structural and functional entities”.

This publication was made possible by an NPRP grant 5-298-3-086 from the Qatar National Research Fund (a member of the Qatar Foundation) to Teun Boekhout. The statements herein are solely the responsibility of the authors.

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The manuscript does not contain clinical studies or patient data.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Advanced Research Centre for Bionanoconjugates and Biopolymers, Institute of Macromolecular Chemistry “Petru Poni”, 700487, Iasi, Romania

    B. Minea, N. Marangoci & M. Pinteala

  2. Laboratory of Antimicrobial Chemotherapy, “Ion Ionescu de la Brad” University, 8 Aleea Sadoveanu, P4, 1st floor, 700489, Iasi, Romania

    V. Nastasa, R. F. Moraru & M. Mares

  3. Yeast and Basidiomycete Research, CBS Fungal Biodiversity Centre (CBS-KNAW), 3508 AD, Utrecht, The Netherlands

    A. Kolecka & T. Boekhout

  4. Microbiology Laboratory, Clinical Hospital of Infectious Diseases, 400348, Cluj-Napoca, Romania

    M. M. Flonta

  5. Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041, Timisoara, Romania

    I. Marincu

  6. Department of Microbiology, Virology and Parasitology, University of Medicine and Pharmacy, 540139, Tirgu Mures, Romania

    A. Man & F. Toma

  7. Department of Infectious Diseases, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012, Cluj-Napoca, Romania

    M. Lupse

  8. 2nd Clinic of Obstetrics and Gynaecology, “Gr. T. Popa” University of Medicine and Pharmacy, 700115, Iasi, Romania

    B. Doroftei

  9. Department of Reproductive Medicine, Origyn Fertility Center, 700400, Iasi, Romania

    B. Doroftei

  10. Department of Dermatology, Institute of Dermatology and Medical Mycology, Shanghai Key Laboratory of Molecular Medical Mycology, Second Military Medical University, Changzheng Hospital, 200003, Shanghai, People’s Republic of China

    T. Boekhout

  11. Institute of Microbiology, State Key Laboratory of Mycology, Chinese Academy of Sciences, 100101, Beijing, China

    T. Boekhout

Authors
  1. B. Minea
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  2. V. Nastasa
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  3. R. F. Moraru
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  4. A. Kolecka
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  5. M. M. Flonta
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  6. I. Marincu
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  7. A. Man
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  8. F. Toma
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  9. M. Lupse
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  10. B. Doroftei
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  11. N. Marangoci
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  12. M. Pinteala
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  13. T. Boekhout
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  14. M. Mares
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Corresponding author

Correspondence to M. Mares.

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Minea, B., Nastasa, V., Moraru, R.F. et al. Species distribution and susceptibility profile to fluconazole, voriconazole and MXP-4509 of 551 clinical yeast isolates from a Romanian multi-centre study. Eur J Clin Microbiol Infect Dis 34, 367–383 (2015). https://doi.org/10.1007/s10096-014-2240-6

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  • DOI: https://doi.org/10.1007/s10096-014-2240-6

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