Antifungal susceptibility profiles and drug resistance mechanisms of clinical Candida duobushaemulonii isolates from China
Xin-Fei Chen, Han Zhang, Xinmiao Jia, Jin Cao, Li Li, Xinlan Hu, Ning Li, Yuling Xiao, Fei Xia, Liyan Ye, Qingfeng Hu, Xiaoli Wu, Li-Ping Ning, Po‐Ren Hsueh, Xin Fan, Shu-Ying Yu, Jingjing Huang, Xiu-Li Xie, Wenhang Yang, Ying-Xing Li, Ge Zhang, Jingjia Zhang, Simeng Duan, Wei Kang, Tong Wang, Jin Li, Meng Xiao, Xin Hou, Ying-Chun Xu
Abstract
Candida duobushaemulonii , type II Candida haemulonii complex, is closely related to Candida auris and capable of causing invasive and non-invasive infections in humans. Eleven strains of C . duobushaemulonii were collected from China Hospital Invasive Fungal Surveillance Net (CHIF-NET) and identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF), VITEK 2 Yeast Identification Card (YST), and internal transcribed spacer (ITS) sequencing. Whole genome sequencing of C . duobushaemulonii was done to determine their genotypes. Furthermore, C . duobushaemulonii strains were tested by Sensititre YeastOne™ and Clinical and Laboratory Institute (CLSI) broth microdilution panel for antifungal susceptibility. Three C . duobushaemulonii could not be identified by VITEK 2. All 11 isolates had high minimum inhibitory concentrations (MICs) to amphotericin B more than 2 μg/ml. One isolate showed a high MIC value of ≥64 μg/ml to 5-flucytosine. All isolates were wild type (WT) for triazoles and echinocandins. FUR1 variation may result in C . duobushaemulonii with high MIC to 5-flucytosine. Candida duobushaemulonii mainly infects patients with weakened immunity, and the amphotericin B resistance of these isolates might represent a challenge to clinical treatment.