Volume 24, Number 9—September 2018
Research Letter
Fluconazole-Resistant Candida parapsilosis Bloodstream Isolates with Y132F Mutation in ERG11 Gene, South Korea
Yong Jun Choi1, Yae-Jean Kim1, Dongeun Yong, Jung-Hyun Byun, Taek Soo Kim, Yun Sil Chang, Min Ji Choi, Seung Ah Byeon, Eun Jeong Won, Soo Hyun Kim, Myung Geun Shin, and Jong Hee Shin
Table
Molecular characterization of 47 fluconazole-resistant isolates and 20 fluconazole-susceptible isolates of Candida parapsilosis, South Korea*
| Microsatellite
genotypes† |
Hospital |
No. isolates |
MICs, mg/L‡ | Amino acid substitutions§ | Isolation year (no. patients) |
|||||
|---|---|---|---|---|---|---|---|---|---|---|
| FLC |
VRC |
Erg11p |
Mrr1p |
Tac1p |
Upc2p |
|||||
| Fluconazole-resistant with Y132F in Erg11p, n = 30 isolates | ||||||||||
| M1 | A | 8 | 8–32 | 0.25–0.5 | Y132F | K177N | 2006 (1), 2009 (1), 2010 (2), 2011 (2), 2012 (1), 2013 (1) | |||
| B | 3 | 16–32 | 0.5 | Y132F | K177N | 2012 (2), 2013 (1) | ||||
| M2 | A | 10 | 8–32 | 0.125–0.5 | Y132F | K177N | 2012 (1), 2016 (9) | |||
| M3 | A | 3 | 8–16 | 0.25 | Y132F | K177N, Q1053* | 2007 (1), 2011 (1), 2012 (1) | |||
| M4 | A | 2 | 8–>64 | 0.5–4 | Y132F | K177N | 2013 (1), 2016 (1) | |||
| M5 | A | 1 | 32 | 0.25 | Y132F | K177N | 2012 (1) | |||
| M6 | A | 1 | 8 | 0.5 | Y132F | K177N | 2013 (1) | |||
| M7 | A | 1 | 8 | 0.25 | Y132F | K177N | 2016 (1) | |||
| M8 |
C |
1 |
64 |
2 |
Y132F |
2016 (1) |
||||
| Other fluconazole-resistant, n = 17 isolates | ||||||||||
| M9 | D | 2 | >64 | 1 | G583R | 2007 (1), 2009 (1) | ||||
| M10 | E | 1 | 16 | 0.5 | R398I | L877P | 2005 (1) | |||
| M11 | A | 1 | 8 | 0.25 | 2006 (1) | |||||
| M12 | E | 1 | 8 | 0.25 | R398I | L877P | 2011 (1) | |||
| M13 | F | 1 | 16 | 0.06 | R398I | L877P | 2011 (1) | |||
| M14 | E | 1 | 8 | 0.125 | R398I | L877P | 2012 (1) | |||
| M15 | G | 1 | 8 | 0.125 | R398I | L877P | 2012 (1) | |||
| M16 | G | 1 | 8 | 0.06 | R398I | L877P | 2012 (1) | |||
| M17 | E | 1 | 8 | 0.125 | N900D | 2012 (1) | ||||
| M18 | C | 1 | 8 | 0.125 | R398I | P250S | L877P | 2012 (1) | ||
| M19 | C | 1 | 8 | 0.25 | R398I | S1081P | L877P | 2012 (1) | ||
| M20 | D | 1 | 8 | 0.125 | R398I | D394N | 2012 (1) | |||
| M21 | E | 1 | 32 | 0.5 | R398I | P295R | L877P | 2015 (1) | ||
| M22 | E | 1 | 16 | 0.125 | R398I | 2015 (1) | ||||
| M23 | H | 1 | 32 | 0.125 | K128N | W872C | 2015 (1) | |||
| M24 |
E |
1 |
16 |
0.25 |
G927D |
2016 (1) |
||||
| Fluconazole-susceptible controls | ||||||||||
| M3 | A | 1 | 1 | 0.03 | K177N, Q1053* | 2010 (1) | ||||
| M25 | C | 2 | 0.5 | 0.03 | R398I | 2012 (2) | ||||
| M26 | F | 2 | 0.5 | 0.03–0.06 | R208G | 2012 (1), 2013 (1) | ||||
| M27 | A | 1 | 2 | 0.06 | 2010 (1) | |||||
| M28 | A | 1 | 0.5 | 0.03 | K177N, Q1053* | 2011 (1) | ||||
| M29 | A | 1 | 1 | 0.06 | L877P | 2011 (1) | ||||
| M30 | A | 1 | 1 | 0.03 | R208G | 2012 (1) | ||||
| M31 | A | 1 | 0.5 | 0.03 | R208G | 2012 (1) | ||||
| M32 | E | 1 | 2 | 0.03 | 2012 (1) | |||||
| M33 | G | 1 | 0.5 | 0.03 | R208G | 2012 (1) | ||||
| M34 | G | 1 | 0.5 | 0.03 | 2012 (1) | |||||
| M35 | A | 1 | 0.5 | 0.03 | R208G | 2013 (1) | ||||
| M36 | A | 1 | 1 | 0.06 | R398I | D394N | 2013 (1) | |||
| M37 | A | 1 | 0.5 | 0.03 | R398I | 2013 (1) | ||||
| M38 | D | 1 | 0.5 | 0.06 | R398I | 2014 (1) | ||||
| M39 | D | 1 | 0.5 | 0.06 | R208G | 2014 (1) | ||||
| M40 | E | 1 | 0.5 | 0.03 | R208G | 2015 (1) | ||||
| M41 | A | 1 | 1 | 0.03 | R398I | L877P | 2015 (1) | |||
*CLSI, Clinical and Laboratory Standards Institute; FLC, fluconazole; VRC, voriconazole.
†For microsatellite typing, each strain was characterized by a genotype resulting from combination of the sizes of the 4 markers (CP1, CP4, CP6, and B). See the Technical Appendix Figure for results of microsatellite genotyping presented as an UPGMA tree.
‡Antifungal MICs were determined by the CLSI M27–A3 broth microdilution method (7). The fluconazole MICs of 30 Y132F isolates determined by Etest were ≥8 mg/L. All 67 isolates tested were susceptible to amphotericin B (MIC 0.25–1 mg/L) and micafungin (MIC 0.25–2 mg/L) according to the CLSI method.
§All were homozygote alleles except for 6 heterozygote alleles (Q1053,* G583R, P250S, P295R, W872C, and G927D) in Mrr1p.
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1These authors contributed equally to this article.
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