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Isolation and Drug Susceptibility of Candida parapsilosis Sensu Lato and other Species of C. parapsilosis Complex from Patients with Blood Stream Infections and Proposal of a Novel LAMP Identification Method for the Species

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Abstract

Candida parapsilosis complex (CPC) is the third Candida species isolated in blood cultures of patients from our Hospital, following C. albicans and C. tropicalis. From 2006 to 2010, the median annual distribution of CPC was 8 cases/year. Records of 36 patients were reviewed. CPC were 31 (86.1 %) C. parapsilosis; 4 (11.1 %) C. orthopsilosis; and 1 (2.8 %) C. metapsilosis. Clinical characteristics were central venous catheter, 34 (94.4 %); parental nutrition, 25 (70 %); surgery, 27 (57.9 %); prior bacteremia, 20 (51.3 %); malignancy, 18 (50 %). General mortality was 47.2 %. Death was higher in immunosuppressed patients (17 vs. 11; p = 0.003). Three out four (75 %) patients with C. orthopsilosis and 14 out 31 (45.2 %) with C. parapsilosis died (p = 0.558). Thirty-nine individual isolates were tested for susceptibility to seven antifungal drugs, with MICs values showing susceptibility to all of them. Two isolates, one C. orthopsilosis and one C. parapsilosis, had fluconazole MIC = 4 μg/mL. Differentiation among CPC has implication in caring for patients with invasive candidiasis since there are differences in virulence, pathogenicity and drug susceptibility. A method targeting the topoisomerase II gene based on loop-mediated isothermal amplification (LAMP) was developed. LAMP emerges as a promising tool for the identification of fungal species due to the high sensitivity and specificity. LAMP can be performed at the point-of-care, being no necessary the use of expensive equipment. In our study, the method was successful comparing to the DNA sequencing and proved to be a reliable and fast assay to distinguish the three species of CPC.

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Acknowledgments

This project was approved on February 22, 2011 (No. 039/2011) by the Ethical Committee of the School of Medical Sciences of the University of Campinas. This study was partly supported by JICA (Japan International Cooperation Agency) and SATREPS (Science and Technology Research Partnership for Sustainable Development) Grant No. 02P-29548-09.

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All authors declare no conflict of interests.

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Authors and Affiliations

  1. Infectious Diseases Division, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Carvalho, 126 Cidade Universitária Zeferino Vaz, Campinas, Sao Paulo, 13083-887, Brazil

    Plinio Trabasso, Renata Fagnani, Mariangela Ribeiro Resende & Maria Luiza Moretti

  2. University of Nagasaki, 1-1-1 Manabino, Nagayo-cho, Nishi-Sonogi-gun, Nagasaki, 851-2195, Japan

    Tetsuhiro Matsuzawa

  3. Medical Mycology Research Center, Chiba University, 1-8-1, Inohana, Chuoku, 260-8673, Japan

    Yasunori Muraosa, Kenichiro Tominaga, Katsuhiko Kamei & Yuzuru Mikami

  4. Department of Clinical Pathology, School of Medical Sciences, University of Campinas, Rua Tessália Vieira de Carvalho, 126 Cidade Universitária Zeferino Vaz, Campinas, Sao Paulo, 13083-887, Brazil

    Angelica Zaninelli Schreiber

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  1. Plinio Trabasso
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  2. Tetsuhiro Matsuzawa
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Correspondence to Plinio Trabasso.

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The authors are grateful to Mrs. Luzia Lyra and Eliene Pinheiro for their notable contribution.

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Trabasso, P., Matsuzawa, T., Fagnani, R. et al. Isolation and Drug Susceptibility of Candida parapsilosis Sensu Lato and other Species of C. parapsilosis Complex from Patients with Blood Stream Infections and Proposal of a Novel LAMP Identification Method for the Species. Mycopathologia 179, 53–62 (2015). https://doi.org/10.1007/s11046-014-9830-9

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