The Risk Factors and Mechanisms of Azole Resistance of Candida tropicalis Blood Isolates in Thailand: A Retrospective Cohort Study
Issued Date
2022-10-01
Resource Type
eISSN
2309608X
Scopus ID
2-s2.0-85140889525
Journal Title
Journal of Fungi
Volume
8
Issue
10
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Fungi Vol.8 No.10 (2022)
Suggested Citation
Leepattarakit T., Tulyaprawat O., Ngamskulrungroj P. The Risk Factors and Mechanisms of Azole Resistance of Candida tropicalis Blood Isolates in Thailand: A Retrospective Cohort Study. Journal of Fungi Vol.8 No.10 (2022). doi:10.3390/jof8100983 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/83116
Title
The Risk Factors and Mechanisms of Azole Resistance of Candida tropicalis Blood Isolates in Thailand: A Retrospective Cohort Study
Author(s)
Author's Affiliation
Other Contributor(s)
Abstract
In recent decades, an epidemiological shift has been observed from Candida infections to non-albicans species and resistance to azoles. We investigated the associated factors and molecular mechanisms of azole-resistant blood isolates of C. tropicalis. Full-length sequencing of the ERG11 gene and quantitative real-time RT-PCR for the ERG11, MDR1, and CDR1 genes were performed. Male sex (odds ratio, 0.38), leukemia (odds ratio 3.15), and recent administration of azole (odds ratio 10.56) were associated with isolates resistant to azole. ERG11 mutations were found in 83% of resistant isolates, with A395T as the most common mutation (53%). There were no statistically significant differences in the expression of the ERG11, MDR1, and CDR1 genes between the groups resistant and susceptible to azole. The prevalence of azole-resistant isolates was higher than the usage of antifungal drugs, suggesting the possibility of environmental transmission in the healthcare setting. The unknown mechanism of the other 17% of the resistant isolates remains to be further investigated.