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Candidemia Among Hospitalized Pediatric Patients Caused by Several Clonal Lineages of Candida Parapsilosis Publisher



Hare RK1 ; Arastehfar A2 ; Rosendahl S3 ; Charsizadeh A4 ; Daneshnia F2 ; Eshaghi H5 ; Mirhendi H6, 7 ; Boekhout T8, 9 ; Hagen F8, 10 ; Arendrup MC1, 11, 12
Authors
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Authors Affiliations
  1. 1. Unit of Mycology, Statens Serum Institut, Copenhagen, DK-2300, Denmark
  2. 2. The Institute for Cancer and Infectious Diseases, Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, 07110, NJ, United States
  3. 3. Department of Biology, University of Copenhagen, Copenhagen, DK-2200, Denmark
  4. 4. Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, 14496-14535, Iran
  5. 5. Division of Infectious Diseases, Department of Pediatrics, Tehran University of Medical Sciences, Tehran, 14496-14535, Iran
  6. 6. Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, 8174673461, Iran
  7. 7. Reference Mycology Laboratory, Isfahan University of Medical Sciences, Isfahan, 8174673461, Iran
  8. 8. Westerdijk Fungal Biodiversity Institute, Utrecht, 3584 CT, Netherlands
  9. 9. Institute of Biodiversity and Ecosystem Dynamics, University of Amsterdam, Amsterdam, 1012 WX, Netherlands
  10. 10. Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, 3584 CX, Netherlands
  11. 11. Department of Clinical Microbiology, University Hospital Rigshospitalet, Copenhagen, DK-2100, Denmark
  12. 12. Department of Clinical Medicine, University of Copenhagen, Copenhagen, DK-2200, Denmark

Source: Journal of Fungi Published:2022


Abstract

Candida parapsilosis is the second most common cause of candidemia in some geographical areas and in children in particular. Yet, the proportion among children varies, for example, from 10.4% in Denmark to 24.7% in Tehran, Iran. As this species is also known to cause hospital outbreaks, we explored if the relatively high number of C. parapsilosis pediatric cases in Tehran could in part be explained by undiscovered clonal outbreaks. Among 56 C. parapsilosis complex isolates, 50 C. parapsilosis were genotyped by Amplified Fragment Length Polymorphism (AFLP) fingerprinting and microsatellite typing and analyzed for nucleotide polymorphisms by FKS1 and ERG11 sequencing. AFLP fingerprinting grouped Iranian isolates in two main clusters. Microsatellite typing separated the isolates into five clonal lineages, of which four were shared with Danish isolates, and with no correlation to the AFLP patterns. ERG11 and FKS1 sequencing revealed few polymorphisms in ERG11 leading to amino-acid substitutions (D133Y, Q250K, I302T, and R398I), with no influence on azole-susceptibilities. Collectively, this study demonstrated that there were no clonal outbreaks at the Iranian pediatric ward. Although possible transmission of a diverse C. parapsilosis community within the hospital cannot be ruled out, the study also emphasizes the necessity of applying appropriately discriminatory methods for outbreak investigation. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
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