title: Species Distribution, Virulence Factors, and Antifungal Susceptibility Among Candida parapsilosis Complex Isolates Recovered from Clinical Specimens.
abstract: The Candida parapsilosis complex has emerged as an important fungal pathogen. In spite of this, relatively little is known about its characteristics. Thus, the purposes of this study were (1) to determine by BanI-RFLP-assay the occurrence of C. parapsilosis complex species among 81 clinical isolates primarily identified as C. parapsilosis; (2) to evaluate their in vitro production of virulence factors; and (3) to compare their susceptibility profiles, grown as planktonic cells and biofilms, against amphotericin B, fluconazole, voriconazole, and caspofungin by following the Clinical and Laboratory Standards Institute (CLSI) guidelines. Seventy-seven isolates (95%) were identified as C. parapsilosis sensu stricto, 2 (2.5%) as C. orthopsilosis, and 2 (2.5%) as C. metapsilosis. Protease activity was detected in 29 (37.7%) isolates of C. parapsilosis sensu stricto, whereas only 7 (9.1%) exhibited phospholipase activity. None of the C. metapsilosis or C. orthopsilosis was able to produce protease or phospholipase. Biofilm production was detected in 35 (43.2%) isolates, among which 33 were C. parapsilosis sensu stricto and 2 were C. orthopsilosis. Antifungal resistance was uncommon; only one C. metapsilosis was fluconazole resistant. However, biofilm-producing isolates showed a marked resistance to all antifungal agents tested, particularly to voriconazole. This knowledge could be of clinical relevance for guiding therapeutic decisions.
authors.affiliation: Laboratório de Microbiologia, Departamento de Microbiologia, Imunologia e Parasitologia, Instituto de Ciências Biológicas e Naturais, Universidade Federal do Triângulo Mineiro, Praça Manoel Terra 330, Uberaba, Minas Gerais, 38025-015, Brazil.
authors.forename: Beatriz Virgínia
authors.initials: BV
authors.lastname: da Silva
authors.affiliation: Laboratório de Microbiologia, Departamento de Microbiologia, Imunologia e Parasitologia, Instituto de Ciências Biológicas e Naturais, Universidade Federal do Triângulo Mineiro, Praça Manoel Terra 330, Uberaba, Minas Gerais, 38025-015, Brazil.
authors.forename: Larissa Beatriz
authors.initials: LB
authors.lastname: Silva
authors.affiliation: Laboratório de Microbiologia, Departamento de Microbiologia, Imunologia e Parasitologia, Instituto de Ciências Biológicas e Naturais, Universidade Federal do Triângulo Mineiro, Praça Manoel Terra 330, Uberaba, Minas Gerais, 38025-015, Brazil.
authors.forename: Diego Batista Carneiro
authors.initials: DB
authors.lastname: de Oliveira
authors.affiliation: Disciplina de Microbiologia, CEFORES, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: da Silva
authors.affiliation: Unidade de Doenças Infecciosas, Instituto de Ciências da Saúde, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.
authors.forename: Kennio
authors.initials: K
authors.lastname: Ferreira-Paim
authors.affiliation: Unidade de Doenças Infecciosas, Instituto de Ciências da Saúde, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.
authors.forename: Leonardo Euripides
authors.initials: LE
authors.lastname: Andrade-Silva
authors.affiliation: Unidade de Doenças Infecciosas, Instituto de Ciências da Saúde, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.
authors.forename: Mario León
authors.initials: ML
authors.lastname: Silva-Vergara
authors.affiliation: Laboratório de Microbiologia, Departamento de Microbiologia, Imunologia e Parasitologia, Instituto de Ciências Biológicas e Naturais, Universidade Federal do Triângulo Mineiro, Praça Manoel Terra 330, Uberaba, Minas Gerais, 38025-015, Brazil. anderson@icbn.uftm.edu.br.
authors.forename: Anderson Assunção
authors.initials: AA
authors.lastname: Andrade
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000494:pharmacology*; D018441:Biofilms / Q000254:growth & development; D002175:Candida / Q000145:classification* / Q000187:drug effects* / Q000302:isolation & purification / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005838:Genotype; D006801:Humans; D006867:Hydrolases / Q000032:analysis; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D058889:Molecular Typing; D016533:Mycological Typing Techniques; D012150:Polymorphism, Restriction Fragment Length; D037521:Virulence Factors / Q000032:analysis*; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D037521:Virulence Factors; D006867:Hydrolases
keywords: Antifungal susceptibility; Biofilm production; Candida parapsilosis complex; Proteases and phospholipases; Virulence factors