Development of fluconazole resistance in a series of Candida parapsilosis isolates from a persistent candidemia patient with prolonged antifungal therapy

Table 1 C. parapsilosis strains information, antifungal susceptibilities, microsatellite typing results and the MRR1 gene mutations

Strain no.^a	Patient	Ward^b	Susceptibility results by Sensititre YeastOne^c (μg/mL)									Multilocus genotype^d				Genotype^e	MRR1
Strain no.^a	Patient	Ward^b	FLC	VRC	ITC	POS	ANF	MCF	CAS	5FC	AMB	B5	CP1	CP4	CP6	Genotype^e	MRR1
PU017	1	EGW	2	0.03	0.12	0.06	0.5	0.5	0.25	0.06	0.5	109/109	242/242	307/307	291/291	A	T2957C/WT
PU110	1	EGW	2	0.03	0.12	0.06	0.5	0.5	0.25	0.06	0.5	109/109	242/242	307/307	291/291	A	T2957C/WT
PU112	1	EGW	2	0.03	0.06	0.06	0.25	0.25	0.25	0.06	0.5	109/109	242/242	307/307	291/291	A	T2957C/WT
PU116	1	EGW	2	0.03	0.06	0.06	0.5	0.5	0.25	0.06	0.5	109/109	242/242	307/307	291/291	A	T2957C/WT
PU123	1	EGW	32	0.5	0.12	0.06	0.5	0.5	0.5	0.06	0.5	109/109	242/242	307/307	291/291	A	T2957C/T2957C
PU127	1	EGW	32	0.5	0.12	0.06	0.5	0.5	0.5	0.06	0.5	109/109	242/242	307/307	291/291	A	T2957C/T2957C
PU004	2	Outpatient	0.5	≤0.008	0.06	0.03	0.5	0.5	0.25	0.06	0.5	107/107	242/242	307/307	267/267	B	WT/WT
PU026	3	ICU	0.25	≤0.008	0.03	0.03	0.5	0.5	0.25	0.06	0.5	143/145	242/242	304/304	282/282	C	WT/WT
PU090	4	Medical ward	0.5	≤0.008	0.03	0.03	0.5	0.5	0.25	≤0.06	0.5	113/129	224/245	358/358	267/270	D	WT/WT
PU106	5	Surgical ward	0.5	≤0.008	0.06	0.03	0.5	0.25	0.12	0.06	0.5	109/109	242/242	307/307	291/291	A^f	WT/WT
PU108	6	EGW	0.5	≤0.008	0.06	0.03	0.5	0.5	0.25	0.12	0.5	115/129	242/248	364/385	267/267	E	WT/WT
PU131	7	Medical ward	0.5	≤0.008	0.03	0.015	0.5	0.5	0.25	0.12	0.5	109/109	242/242	307/307	288/288	F	WT/WT
ATCC 22019	-	-	1	0.015	0.12	0.03	0.5	0.5	0.25	0.12	0.5	129/129	245/251	304/304	291/291	G	WT/WT

^aAll strains were isolated from blood cultures
^bEGW Emergency general ward
^cFLC Fluconazole, VRC Voriconazole, ITC Itraconazole, POS Posaconazole, ANF Anidulafungin, MCF, Micafungin, CAS Caspofungin, 5FC 5-Flucytosine, AMB Amphotericin B. Clinical breakpoints for susceptible, intermediate, and resistant for C. parapsilosis, respectively, were those of the CLSI M27-S4 for fluconazole (≤2/4/ ≥8 μg/mL); and for voriconazole (≤0.125/0.25/≥1 μg/mL); and for anidulafungin, caspofungin, and micafungin (≤2/4/≥8 μg/mL)
^dThe numbers indicate the fragment size in base pairs of the different alleles obtained with the listed marker
^eThe genotype was designated according to the different microsatellite typing results
^fThe PU106 isolate yielded identical genotype with the isolates from patient 1

ISSN: 1471-2334