文献类型： 外文期刊

作者： Gong, Jie ¹ ; Chen, Xin-Fei ² ; Fan, Xin ⁴ ; Xu, Juan ¹ ; Zhang, Han ² ; Li, Ruo-Yu ⁶ ; Chen, Sharon C-A ⁹ ; Kong, Fanrong ⁹ ; Zhang, Shu ¹ ; Sun, Zi-Yong ¹⁰ ; Kang, Mei ¹¹ ; Liao, Kang ¹² ; Guo, Da-Wen ¹³ ; Wan, Zhe ⁶ ; Hu, Zhi-Dong ¹⁴ ; Chu, Yun-Zhuo ¹⁵ ; Zhao, Hong-Mei ¹⁶ ; Zou, Gui-Ling ¹⁷ ; Shen, Chong ¹⁸ ; Geng, Yuan-Yuan ¹ ; Wu, Wei-Wei ²⁰ ; Wang, He ²¹ ; Zhao, Fei ¹ ; Lu, Xin ¹ ; He, Li-Hua ¹ ; Liu, Gui-Ming ²² ; Xu, Ying-Chun ² ; Zhang, Jian-Zhong ¹ ; Xiao, Meng ² ;

作者机构： 1.Chinese Ctr Dis Control & Prevent, Natl Inst Communicable Dis Control & Prevent, Collaborat Innovat Ctr Diag & Treatment Infect Di, State Key Lab Infect Dis Prevent & Control, Beijing, Peoples R China

2.Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Lab Med, Sate Key Lab Complex Severe & Rare Dis, Beijing, Peoples R China

3.Beijing Key Lab Mech Res & Precis Diag Invas Fung, Beijing, Peoples R China

4.Capital Med Univ, Beijing Inst Resp Med, Dept Infect Dis & Clin Microbiol, Beijing, Peoples R China

5.Capital Med Univ, Beijing Chao Yang Hosp, Beijing, Peoples R China

6.Beijing Univ First Hosp, Dept Dermatol, Beijing, Peoples R China

7.Beijing Key Lab Mol Diag Dermatoses, Beijing, Peoples R China

8.Beijing Univ, Res Ctr Med Mycol, Beijing, Peoples R China

9.Univ Sydney, Westmead Hosp, Inst Clin Pathol & Med Res, Ctr Infect Dis & Microbiol Lab Serv,New South Wal, Sydney, NSW, Australia

10.Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Clin Lab, Wuhan, Hubei, Peoples R China

11.Sichuan Univ, West China Hosp, Dept Lab Med, Chengdu, Sichuan, Peoples R China

12.Sun Yat Sen Univ, Affiliated Hosp 1, Dept Clin Lab, Guangzhou, Peoples R China

13.Harbin Med Univ, Affiliated Hosp 1, Dept Clin Lab, Harbin, Heilongjiang, Peoples R China

14.Tianjin Med Univ Gen Hosp, Dept Clin Lab, Tianjin, Peoples R China

15.China Med Univ, Hosp 1, Dept Clin Lab, Shenyang, Liaoning, Peoples R China

16.Peoples Hosp Liaoning Prov, Dept Clin Lab, Shenyang, Liaoning, Peoples R China

17.Harbin Med Univ, Affiliated Hosp 4, Dept Clin Lab, Harbin, Heilongjiang, Peoples R China

18.Tsinghua Univ, Ctr Stat Sci, Beijing, Peoples R China

19.Tsinghua Univ, Dept Ind Engn, Beijing, Peoples R China

20.Fifth Peoples Hosp Hainan Prov, Dept Dermatol, Haikou, Hainan, Peoples R China

21.Beijing Key Lab Mech Res & Precis Diag Invas Fung, Dynamiker Sub Ctr, Tianjin, Peoples R China

22.Beijing Acad Agr & Forestry Sci, Beijing Agro Biotechnol Res Ctr, Beijing, Peoples R China

关键词： Candida albicans; phylogenetic population; azole-resistance; Erg11p; Tac1p; azole-nonsusceptibility

期刊名称：MICROBIOLOGY SPECTRUM （ 影响因子：3.7； 五年影响因子：5.9 ）

ISSN： 2165-0497

年卷期： 2023 年

页码：

收录情况： SCI

摘要： Candida albicans remains the most common species causing invasive candidiasis. In this study, we present the population structure of 551 global C. albicans strains. Of these, the antifungal susceptibilities of 370 strains were tested. Specifically, 66.6% of the azole-nonsusceptible (NS)/non-wild-type (NWT) strains that were tested belonged to Clade 1. A phylogenetic analysis, a principal components analysis, the population structure, and a loss of heterozygosity events revealed two nested subclades in Clade 1, namely, Clade 1-R and Clade 1-R-alpha, that exhibited higher azole-NS/NWT rates (75.0% and 100%, respectively). In contrast, 6.4% (21/326) of the non-Clade 1-R isolates were NS/NWT to at least 1 of 4 azoles. Notably, all of the Clade 1-R-alpha isolates were pan-azole-NS/NWT that carried unique A114S and Y257H double substitutions in Erg11p and had the overexpression of ABC-type efflux pumps introduced by the substitution A736V in transcript factor Tac1p. It is worth noting that the Clade 1-R and Clade 1-R-alpha isolates were from different cities that are distributed over a large geographic span. Our study demonstrated the presence of specific phylogenetic subclades that are associated with antifungal resistance among C. albicans Clade 1, which calls for public attention on the monitoring of the future spread of these clones.IMPORTANCE Invasive candidiasis is the most common human fungal disease among hospitalized patients, and Candida albicans is the predominant pathogen. Considering the large number of infected cases and the limited alternative therapies, the azole-resistance of C. albicans brings a huge clinical threat. Here, our study suggested that antifungal resistance in C. albicans could also be associated with phylogenetic lineages. Specifically, it was revealed that more than half of the azole-resistant C. albicans strains belonged to the same clade. Furthermore, two nested subclades of the clade exhibited extremely high azole-resistance. It is worth noting that the isolates of two subclades were from different cities that are distributed over a large geographic span in China. This indicates that the azole-resistant C. albicans subclades may develop into serious public health concerns. Invasive candidiasis is the most common human fungal disease among hospitalized patients, and Candida albicans is the predominant pathogen. Considering the large number of infected cases and the limited alternative therapies, the azole-resistance of C. albicans brings a huge clinical threat.