Genetic diversity of Candida parapsilosis (sensu stricto): correlation of emerging clusters with susceptibility to antifungal drugs, biofilm formation and virulence of isolates obtained from Invasive Candidiasis in a tertiary-care hospital

Abstract

Candida spp. is responsible for more than 80% of nosocomial fungal infections, representing an important cause of morbidity and mortality. Candida parapsilosis is main species in neonatal intensive care units, causing outbreaks through horizontal transmission, to which contributes its high ability to form biofilm and colonize both invasive medical devices and the hands of healthcare professionals. Although C. parapsilosis isolates resistant to antifungal drugs are uncommon, the rate of fluconazole resistance is increasing worlwide, including in Brazil. Therefore, studies on molecular epidemiology of C. parapsilosis (sensu stricto), the main species of C. parapsilosis complex, have been reported. However, in those studies, the association of biofilm formation and virulence of the isolates with transmission, incidence and persistence of specific nosocomial clusters have been underexplored. Thus, studies on the clinical and epidemiological impact of the genotypic diversity of C. parapsilosis (sensu stricto), correlating the genotypes and their phenotypic properties with the clinical characteristics, risk factors and outcome of the patients are highly relevant. The present study aims to map the genotypes of this species in a large Brazilian tertiary-care hospital by microsatellite analysis and whole genome sequencing, and correlate the genotypes with their antifungal susceptibility and biofilm formation profiles as well as with virulence in Galleria mellonella model, in an attempt to identify which phenotypic characteristics are favorable to persistence, in-hospital dispersion and consequent increase in the incidence of identified clusters. (AU)