title: Candidemia surveillance in Brazil: evidence for a geographical boundary defining an area exhibiting an abatement of infections by Candida albicans group 2 strains.
abstract: Prospective population surveillance has been conducted for candidemia in Brazil (A. L. Colombo, M. Nucci, B. J. Park, et al., J. Clin. Microbiol. 44:2816-2823, 2006). In the present study, a total of 63 isolates from 61 patients, representing 11 medical centers from nine geographic regions, were characterized by multilocus sequence typing (MLST). A total of 48 unique profiles or diploid sequence types (DSTs) were observed, with nine new sequence types (STs) and 32 new DSTs. There were no apparent correlations between center/region and DST patterns. Subtypes were compared to those in a known characterized reference set, including a large database of strains obtained worldwide. Significantly, only one C. albicans group 2 isolate was found in our collection, although isolates from this particular group are commonly found worldwide. These data, combined with information from other previously reported studies, establish a statistically significant diminishment of group 2 strains in Central and South America, including Mexico and portions of the Southwestern United States.
authors.affiliation: Division of Infectious Diseases, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Da Matta
authors.forename: Analy S
authors.initials: AS
authors.lastname: Melo
authors.forename: Arnaldo L
authors.initials: AL
authors.lastname: Colombo
authors.forename: Joao P
authors.initials: JP
authors.lastname: Frade
authors.forename: Marcio
authors.initials: M
authors.lastname: Nucci
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Lott
mesh_terms: D001938:Brazil / Q000453:epidemiology; D002175:Candida / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D002177:Candidiasis / Q000453:epidemiology*; D016172:DNA Fingerprinting; D004271:DNA, Fungal / Q000737:chemistry / Q000235:genetics; D016469:Fungemia / Q000453:epidemiology*; D005843:Geography; D006801:Humans; D017720:Molecular Epidemiology; D016533:Mycological Typing Techniques; D017422:Sequence Analysis, DNA
chemical_list: D004271:DNA, Fungal