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Article

The Risk Factors and Mechanisms of Azole Resistance of Candida tropicalis Blood Isolates in Thailand: A Retrospective Cohort Study

by
Teera Leepattarakit
,
Orawan Tulyaprawat
and
Popchai Ngamskulrungroj
*
Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand
*
Author to whom correspondence should be addressed.
J. Fungi 2022, 8(10), 983; https://doi.org/10.3390/jof8100983
Submission received: 23 July 2022 / Revised: 16 September 2022 / Accepted: 17 September 2022 / Published: 20 September 2022
(This article belongs to the Special Issue Invasive Candidiasis)
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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.
Keywords: Candida tropicalis; azole resistance; risk factors Candida tropicalis; azole resistance; risk factors

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MDPI and ACS Style

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. J. Fungi 2022, 8, 983. https://doi.org/10.3390/jof8100983

AMA Style

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. 2022; 8(10):983. https://doi.org/10.3390/jof8100983

Chicago/Turabian Style

Leepattarakit, Teera, Orawan Tulyaprawat, and Popchai Ngamskulrungroj. 2022. "The Risk Factors and Mechanisms of Azole Resistance of Candida tropicalis Blood Isolates in Thailand: A Retrospective Cohort Study" Journal of Fungi 8, no. 10: 983. https://doi.org/10.3390/jof8100983

APA Style

Leepattarakit, T., Tulyaprawat, O., & Ngamskulrungroj, P. (2022). The Risk Factors and Mechanisms of Azole Resistance of Candida tropicalis Blood Isolates in Thailand: A Retrospective Cohort Study. Journal of Fungi, 8(10), 983. https://doi.org/10.3390/jof8100983

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