Detection in Orchards of Predominant Azole-Resistant Candida tropicalis Genotype Causing Human Candidemia, Taiwan
Journal
Emerging Infectious Diseases
Journal Volume
30
Journal Issue
11
Pages
2323-2332
Date Issued
2024-11
Author(s)
Kuo-Yun Tseng
Yin-Zhi Chen
Zi-Li Zhou
Min-Nan Tseng
Hsing-Lung Liu
Chi-Jung Wu
Yu-Chieh Liao
Chih-Chao Lin
De-Jiun Tsai
Feng-Jui Chen
Li-Yun Hsieh
Kuan-Chung Huang
Chun-Hua Huang
Kai-Ting Chen
Wen-Li Chu
Chiao-Mei Lin
Shu-Man Shih
Chao Agnes Hsiung
Yee-Chun Chen
Huey-Kang Sytwu
Yun-Liang Yang
Hsiu-Jung Lo
Abstract
Fluconazole-resistant clade 4 Candida tropicalis causing candidemia in humans has been detected in tropical/subtropical areas, including those in China, Singapore, and Australia. We analyzed 704 individual yeasts isolated from fruits, soil, water, and farmers at 80 orchards in Taiwan. The most common pathogenic yeast species among 251 isolates recovered from farmers were Candida albicans (14.7%) and C. parapsilosis (11.6%). In contrast, C. tropicalis (13.0%), C. palmioleophila (6.6%), and Pichia kudriavzevii (6.0%) were prevalent among 453 environmental isolates. Approximately 18.6% (11/59) of C. tropicalis from the environment were resistant to fluconazole, and 81.8% (9/11) of those belonged to the clade 4 genotype. C. tropicalis susceptibility to fluconazole correlated with susceptibilities to the agricultural azole fungicides, difenoconazole, tebuconazole, and triadimenol. Tandem gene duplications of mutated ERG11 contributed to azole resistance. Agriculture environments are a reservoir for azole-resistant C. tropicalis; discontinuing agricultural use of azoles might reduce emergence of azole-resistant Candida spp. strains in humans.
SDGs
Publisher
CENTERS DISEASE CONTROL & PREVENTION
Description
We thank Calvin Kunin, Shau-Ku Huang, Clifford McDonald, Genevieve Milon, and Mark Swofford for their assistance with the manuscript; Pfizer for supplying fluconazole; and Mission Biotech for assistance with techniques for sequencing and real-time PCR. This work was supported in part by grants from the Ministry of Science and Technology, Taiwan (grant nos. 112-2314-B-400-007 and 112-0324-01-30-06) , National Health Research Institutes (grant nos. IV-112-PP-02, IV-112-PP-11, IV-113-PP-01, and IV-113-PP-05) , Taiwan Centers for Disease Control (grant no. MOHW111-CDCC-114-124301) .
Type
journal article