Epidemiology and susceptibility of Nakaseomyces (formerly Candida) glabrata bloodstream isolates from hospitalised adults in South Africa
Author:
Naicker Serisha D1ORCID, Shuping Liliwe1ORCID, Zulu Thokozile G1, Mpembe Ruth S1, Mhlanga Mabatho1, Tsotetsi Ernest M1, Maphanga Tsidiso G1, Govender Nelesh P1234ORCID, Black John, Pearce Vanessa, Hoosen Anwar, Kleinhans Vicky, Karstaedt Alan, Maluleka Caroline, Verwey Charl, Feldman Charles, Moore David, Reubenson Gary, Han Khine Swe Swe, Wadula Jeannette, Nel Jeremy, Lindeque Kathy, Nchabeleng Maphoshane, Samodien Nazlee, du Plessis Nicolette, Bosman Norma, Kularatne Ranmini, Seetharam Sharona, Thomas Teena, Avenant Theunis, Nana Trusha, Chibabhai Vindana, Maharj Adhil, Burra Asmeeta, Naby Fathima, Dawood Halima, Mogamberry Jade, Mlisana Koleka, Sookan Lisha, Ramjathan Praksha, Mahabeer Prasha, Naidoo Romola, Haffejee Sumayya, Coovadia Yacoob, Hamese Ken, Sibiya Ngoaka, Lekalakala Ruth, Hoyland Greta, Lebudi Jacob, Jooste Pieter, Variava Ebrahim, du Plessis Erna, Whitelaw Andrew, Reddy Kessendri, Nicol Mark, Naicker Preneshni, Brink Adrian, Prentice Elizabeth, Zietsman Inge, Botha Maria, Smith Peter, Poswa Xoliswa, Govind Chetna, Pillay Keshree, Budavari Suzy, Haumann Carel, Samuel Catherine, Senekal Marthinus, Dreyer Andries, Ahmed Khatija, Marcus Louis, Lowman Warren, Messina Angeliki, van den Bergh Dena, Swart Karin, Whitney Cynthia, Klugman Keith, Nanoo Ananta, Dreyer Andries, von Gottberg Anne, Smith Anthony, Sooka Arvinda, Miller Cecilia, Sriruttan Charlotte, Cohen Cheryl, Ihekweazu Chikwe, von Mollendorf Claire, du Plessis Desiree, Britz Erika, Radebe Frans, Ntshoe Genevie, Hunt Gillian, Mathema Hlengani, Weyer Jacqueline, Rossouw Jenny, Frean John, Keddy Karen, McCarthy Kerrigan, de Gouveia Linda, Erasmus Linda, Blumberg Lucille, Smith Marshagne, Makgoba Martha, Modise Motshabi, Ismail Nazir, Govender Nelesh, Legare Neo, Page Nicola, Ramalwa Ntsieni, Paulse Nuraan, Vazi Phumeza, Perovic Olga, Crowther-Gibson Penny, Mutevedzi Portia, Manesen Riyadh, Mpembe Ruth, Lengana Sarona, Madhi Shabir, Walaza Sibongile, Lindani Sonwabo, Njikho Sunnieboy, Meiring Susan, Motladiile Thejane, Lebaka Tiisetso, Quan Vanessa, Chetty Verushka,
Affiliation:
1. Centre for Healthcare-Associated Infections, Antimicrobial Resistance and Mycoses, National Institute for Communicable Diseases, a Division of the National Health Laboratory Service , Johannesburg , South Africa 2. School of Pathology, Faculty of Health Sciences, University of the Witwatersrand , Johannesburg , South Africa 3. Division of Medical Microbiology, Faculty of Health Sciences, University of Cape Town , Cape Town , South Africa 4. Institute of Infection and Immunity, St George's University of London, London and Medical Research Council Centre for Medical Mycology, University of Exeter , Exeter , United Kingdom
Abstract
Abstract
During 2016–2017, Nakaseomyces glabrata (formerly Candida glabrata) caused 14% of cases of candidaemia in South Africa. We aimed to describe the clinical characteristics of adults with N. glabrata candidaemia at 20 sentinel hospitals (accounting for 20% (172/917) of cases) and the antifungal susceptibility of the corresponding isolates. A higher proportion of patients with N. glabrata candidaemia were older (median age: 55 years [interquartile range (IQR): 41–65 years] vs. 49 years [IQR: 35-63 years]; p = 0.04), female (87/164, 53% vs. 283/671, 42%; p = 0.01), admitted to a public-sector hospital (152/172, 88% vs. 470/745, 63%; p < 0.001), treated with fluconazole only (most with suboptimal doses) (51/95, 54% vs. 139/361, 39%; p < 0.001), and had surgery (47/172, 27% vs. 123/745, 17%; p = 0.001) and a shorter hospital stay (median 7 days [IQR: 2-20 days] vs. 13 days [IQR: 4-27 days]; p < 0.001) compared to patients with other causes of candidaemia. Eight N. glabrata isolates (6%, 8/131) had minimum inhibitory concentrations in the intermediate or resistant range for ≥ 1 echinocandin and a R1377K amino acid substitution encoded by the hotspot 2 region of the FKS2 gene. Only 11 isolates (8%, 11/131) were resistant to fluconazole. Patients with confirmed N. glabrata candidaemia are recommended to be treated with an echinocandin (or polyene), thus further guideline training is required.
Publisher
Oxford University Press (OUP)
Subject
Infectious Diseases,General Medicine
Cited by
3 articles.
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