Antifungal resistance in yeasts from One Health perspective: A Brazilian study.
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Bastos Rafael Wesley, de Aguiar Peres Nalu Teixeira, da Silva Kássia Jéssica Galdino, Eufrasio Ludmila Gouveia, de Carvalho Daniel Santana, Cruz Gabriela Silva, Lucini Fabíola, Silva Lorena Souza, Silva Sthefany Emanuelle, Vechi Hareton Teixeira, do Monte Alves Manoella, Ribeiro Luciana Rodrigues Ferreira, de Souza Karine Lilian, Moreira José Aparecido, de Souza Janete Gouveia, de Miranda Isabela Lima, de Freitas Gustavo Jose Cota, Leocádio Victor Augusto Teixeira, da Silva Danielle Leticia, Dos Santos Corrêa Lislaina, Rocha Bianca Letícia, Magalhães Martha Helena Chaves, Magalhães Vanessa Caroline Randi, Cenachi Adriana Regina Campolina, Moura Alexandre Sampaio, Azevedo Maria Isabel, Colombo Salene Angelini, de Melo Guedes Glaucia Morgana, Parra Aura Lucia Chacón, Brasil Jaiane Alves, Aguilar Jorge Bryan Andino, Gonçalves Kézia Emily Araújo, Silva Antônio Gabriel Nascimento, da Cruz Gabriel Henrique Rodrigues, Santos Gabriel Vichoski, Morio Florent, Castelo-Branco Débora S C M, Rossato Luana, Santos Daniel Assis
Аннотация
Environmental exposure to fungicides can induce cross-resistance in filamentous fungi, but little is known about their effects on medically important yeasts. This multicenter study investigated the resistance in Candida isolated from different sources and evaluated the influence of clinical and environmental antifungals. Different yeasts were collected from patients, hospital environments, swine, poultry and their surroundings in four different states of Brazil. A total of 571 isolates were identified, of which 82.5 % belonged to the genus Candida. Antifungal susceptibility testing revealed that C. tropicalis had the highest resistance rate (12 %) to fluconazole, followed by C. glabrata and C. albicans with resistance rates of 8 % and 6 %, respectively. Resistance to micafungin was most common in C. glabrata (15 %). For amphotericin B, we identified two non-wild-type isolates, one belonging to the C. tropicalis species and the other to C. glabrata. Most resistant isolates were recovered from patients; however, resistance was also observed in animal and environmental isolates. In addition, susceptibility to tebuconazole, an environmental azole, was evaluated and a cut-off value of 8 μg/mL was proposed to assess potential resistance. Among the isolates, 10.5 % had a high minimum inhibitory concentrations (MIC) for tebuconazole. Moreover, cross-resistance is possible to occur, as 3.6 % of Candida isolates were resistant to fluconazole and had high MIC for tebuconazole, particularly C. albicans, C. tropicalis, and C. krusei. This study demonstrates the importance of monitoring yeast resistance to antifungals and environmental fungicides in different niches, and calls for a multidisciplinary approach to understand multiple factors involved in resistance development.