Abstract
Candida parapsilosis was recently reclassified into three distinct species, C. parapsilosis sensu stricto, C. orthopsilosis, and C. metapsilosis. The aim of this study was to assess the prevalence and the antifungal susceptibility of these species among clinical isolates previously identified by phenotypical methods as C. parapsilosis in the laboratory of parasitology of Farhat Hached Hospital (Sousse, Tunisia). Ninety-six clinical isolates were identified by using a multiplex PCR targeting the gene encoding the ribosomal protein SO 40 (RPSO) and a PCR targeting the ITS region. Ninety one (94.8%) isolates were identified as C. parapsilosis sensu stricto, 3 (3.1%) as C. metapsilosis, and 2 (2.1%) as C. orthopsilosis based on PCRITS. These results were concordant with those achieved by Multiplex PCR-RPSO but the prevalence of C. orthopsilosis and C. metapsilosis seems to be very low in the region. Seventeen of the Candida isolates, C. parapsilosis sensu stricto (12), C. metapsilosis (3) and C. orthopsilosis (2) were assayed by ATB Fungus 3® to assess their susceptibility to Flucytosine, Amphotericin B, Fluconazole, Itraconazole and Voriconazole and by E-test® to assess their susceptibility to Caspofungin. All the isolates were susceptible to the antifungals tested.
Highlights
Candida parapsilosis is an emergent pathogen and has become the second or the third most common Candida species causing invasive and superficial candidiasis [1,2]
Out of 96 C. parapsilosis clinical isolates tested with multiplex PCR-ribosomal protein SO 40 (RPSO), 91 (94.8%) gave the single 100 bp band and were assigned to the most common C. parapsilosis species; 3 (3.1%) gave 2 bands of 100 bp and 150 bp respectively and were identified as C. metapsilosis and 2 (2.1%) gave 2 bands of 100 bp and 200 bp respectively, and were identified as C. orthopsilosis
According to PCR-RPSO and DNA sequencing of ITS region, 91 isolates were identified as C. parapsilosis sensu stricto; three isolates were identified as C. metapsilosis and two isolates identified as C. orthopsilosis
Summary
Candida parapsilosis is an emergent pathogen and has become the second or the third most common Candida species causing invasive and superficial candidiasis [1,2]. The molecular investigations of C. parapsilosis have led to the sequencing of its full genome, which showed high heterogeneity between strains otherwise phenotypically indistinguishable [3,4]. It was established that C. parapsilosis is a complex of three genetically distinct groups: group I, group II and group III [5,6]. Detailed molecular analyses have recently recognized C. parapsilosis groups as separate species named C. parapsilosis, C. orthopsilosis and C. metapsilosis respectively [7]. The differentiation of the three species of C. parapsilosis complex is clinically relevant because of their virulence and their susceptibility to antifungal agents. A study conducted between 1995 and 2009 at the Farhat Hached
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