Candida tropicalis bloodstream infection in two teaching hospitals in Sao Paulo State, Brazil

Abstract

Candidemia is considered one of the most frequent causes of bloodstream infections around the world, causing considerable morbimortality and increasing the length of hospitalization, and overall cost of medical expenses. Aims: To compare molecular methods for characterization of Candida tropicalis isolates of two teaching hospitals; to study the antifungal resistance profile Materials and methods: In this study 61 Candida tropicalis isolates (43 patients) from several unities of Hospital das Clı ́nicas da Faculdade de Medicina da USP and Hospital das Clínicas da UNICAMP have been analyzed by antifungigram and molecular typing. Antifungigram was studied through two methods: CLSI and EUCAST. For molecular characterization, RAPD (Randomic Arbitrary Polymorphic DNA) and Pulsed Field Electrophoresis (PFGE) with restriction enzymes (SfiI, SmaI, BssHII e NaeI) were analyzed. Results: BssHII presented best performance for discrimination of the isolates. PFGE was able to show differences among multiple isolates of the same patient. ‘‘Trailing’’ was observed by CLSI and EUCAST in 30 – 70% of the samples tested with azoles. Resistance to fluconazole was observed in 5% of the isolates. Four patients presented with positive blood culture during antifungal therapy: only one was resistant to fluconazole (CLSI and EUCAST). Conclusions: No correlation was found between genetic variability and resistance profile to antifungal drugs. In this study, specific clones have not been observed in each teaching hospital.