Abstract
Candida tropicalis is a leading cause of non-albicans candidemia in tropical/sub-tropical areas and a predominant genotype of azole-resistant C. tropicalis clinical isolates belongs to clade 4. The aim of this study was to reveal markers for rapidly identifying the predominant azole-resistant Candida tropicalis genotype. We analysed XYR1, one of the six genes used in the multilocus sequence typing analysis, and SNQ2, an ATP-binding cassette (ABC) transporter in 281 C. tropicalis, including 120 and 161 from Taiwan and global areas, respectively. Intriguingly, the first 4-mer of codon sequences ATRA of CTRG_05 978 (96/119vs. 21/162, p<0.001, at phi=0. 679) and the SNQ2 A2977G resulting in amino acid I993V alternation (105/118vs.12/163, p<0.001, at phi=0.81) was significantly associated with the clade 4 genotype. The sensitivity and specificity of the clade 4 genotype detection with a combination of SNPs of CTRG_05 978 and SNQ2 were 0.812 and 0.994, respectively, at phi=0.838. Furthermore, we successfully established a TaqMan SNP genotyping assay to identify the clade 4 genotype. Our findings suggest that to improve the management of C. tropicalis infections, rapidly identifying azole-resistant C. tropicalis by detecting SNPs of CTRG_05 978 and SNQ2 is promising.
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