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Abstract

CLINICAL ISOLATES OF Candida Lusitaniae DURING THE COVID-19 PANDEMIC IN MEXICO

Cudberto Contreras Pérez, Elizabeth González Durán, Patricia Gutiérrez García, M. Dolores Téllez Saucedo, Edgar S. Suro Marín, Liset Pérez Vázquez, Claudia Ríos- Rosas, Claudia E. Wong-Arámbula and José D. Méndez*

Abstract

During the COVID-19 pandemic, opportunistic yeast infections of the Candida genus have increased. In a period of eight months (September 2021 to April 2022), 102 clinical yeast isolates were received, of which 7 were identified as Candida lusitaniae (6.86 %), but only one strain of this pathogen was associated with a patient of COVID-19. Another 10 patients had COVID-19 (10 %) and they had yeast infections, with 2 fatal cases occurring, one due to Candida auris and the other due to Candida parapsilosis. Candida auris was associated in 4 cases, Candida albicans in 4 and Candida duobushaemulonii in 1 case. The seven Candida lusitaniae isolates came from 5 immunocompromised patients with different invasive co-infections. 2 patients were adults, one with COVID-19 and the other with decompensated type 2 diabetes mellitus. The other 3 cases were premature neonates with neonatal bacterial sepsis. In the five hospital units in different geographical areas, control measures were established to prevent the spread of the pathogen and for an additional period of three months, no additional cases were recorded. Isolates were identified by phenotypic tests, biochemical tests (Vitek 2, version 9.1) and molecular tests (PCR and sequencing of the internal spacer region (ITS) of ribosomal DNA (rDNA). Phylogenetic analysis of this region allowed determining the evolutionary relationship among Candida lusitaniae isolates. The excellent reliability of the Vitek system stands out, with a probability of 94 to 97% for the identification of the species involved. No resistant strain was detected, all were sensitive to the 6 antifungals: fluconazole, voriconazole, caspofungin, micafungin, amphotericin B and fluocitosina Special importance is given, in the microscopic characteristics found, as well as the existence of subgroups, which may be related, with the variable behavior of the biochemical characteristics and geographic areas.

Keywords: Humans, COVID-19, Candida lusitaniae, Candida parapsilosis, Candida auris, Candida albicans, Candida duobushaemulonii, Antifungals.


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