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Candidemia by Species of the Candida parapsilosis Complex in Children’s Hospital: Prevalence, Biofilm Production and Antifungal Susceptibility

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Abstract

Opportunistic infections are an increasingly common problem in hospitals, and the yeast Candida parapsilosis has emerged as an important nosocomial pathogen. The aims of this study were to determine and compare (i) the prevalence rate among C. parapsilosis complex organisms isolated from blood in a public children’s hospital in São Paulo state, (ii) the ability of the complex C. parapsilosis species identified to produce biofilm and (iii) the antifungal susceptibility profiles. Forty-nine (49) specimens of isolated blood yeast were analyzed, previously identified as C. parapsilosis by conventional methods. After the molecular analysis, the isolates were characterized as C. parapsilosis sensu stricto (83.7 %), C. orthopsilosis (10.2 %) and C. metapsilosis (6.1 %). All species were able to form biofilm. The species with the highest biofilm production was C. parapsilosis sensu stricto, followed by C. orthopsilosis and further by C. metapsilosis. All of the strains have demonstrated similar susceptibility to fluconazole, caspofungin, voriconazole, cetoconazole and 5-flucytosine. Only one strain of C. parapsilosis was resistant to amphotericin B. Regarding itraconazole, 66.6 and 43.9 % isolates of C. metapsilosis and C. parapsilosis, respectively, have demonstrated to be susceptible dose-dependent, with one isolate of the latter species resistant to the drug. Candida parapsilosis sensu stricto has demonstrated to be the less susceptible, mainly to amphotericin B, caspofungin and “azoles” such as fluconazole. Therefore, C. metapsilosis and C. orthopsilosis are still involved in a restricted number of infections, but these data have become essential for there are very few studies of these species in Latin America.

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Acknowledgments

The authors express their thanks to PhD Marina Korte for her revision of the English text, to CNPQ and FAPESP for their financial support and to Dra. Angela Satie Nishikaku and Ms. Karina Bellinghausen Merseguel for support in the molecular study.

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Authors and Affiliations

  1. Departamento de Microbiologia, Instituto de Ciências Biomédicas II, Universidade de São Paulo (USP), Av. Prof. Lineu Prestes, 1374, Cidade Universitária, São Paulo, SP, 05508900, Brazil

    Luciana da Silva Ruiz, Eriques Gonçalves da Silva, Vanessa Krummer Perinazzo de Oliveira & Claudete Rodrigues Paula

  2. Universidade Do Vale do Paraíba (UNIVAP), Av. Shishima Hifumi, 2911, Urbanova, São José dos Campos, São Paulo, 12244-000, Brazil

    Sonia Khouri

  3. Núcleo de Doenças Infecciosas e Tropicais, Universidade Federal do Mato Grosso (UFMG), Av Fernando Correa da Costa, n 2367, Boa Esperança, Cuiaba, MT, 78060-900, Brazil

    Rosane Christine Hahn

  4. Centro de Ciências Médicas e Farmacêuticas, Colegiado de Farmácia, Universidade Estadual do Oeste do Paraná (UNIOESTE), Rua Universitária, 2069, Universitário Cascavel, Paraná, 85814-110, Brazil

    Rinaldo Ferreira Gandra

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  1. Luciana da Silva Ruiz
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Correspondence to Luciana da Silva Ruiz.

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Ruiz, L.S., Khouri, S., Hahn, R.C. et al. Candidemia by Species of the Candida parapsilosis Complex in Children’s Hospital: Prevalence, Biofilm Production and Antifungal Susceptibility. Mycopathologia 175, 231–239 (2013). https://doi.org/10.1007/s11046-013-9616-5

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