Analysis of an outbreak of echinocandin-resistant clonal Candida parapsilosis complex harbouring ERG11Y132F and FKS1S656P mutations

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dc.contributor.authorKapmaza, M.
dc.contributor.authorDogan, O.
dc.contributor.authorIrkoren, P.
dc.contributor.authorCam, K.
dc.contributor.authorTanriverdi, E. S.
dc.contributor.authorGenc, Z.
dc.contributor.authorTas, E.
dc.date.accessioned2026-04-04T13:35:00Z
dc.date.available2026-04-04T13:35:00Z
dc.date.issued2026
dc.departmentİnönü Üniversitesi
dc.description.abstractAim: We aimed to analyse echinocandin-resistant (ECR) Candida parapsilosis complex candidaemia episodes. Methods: A retrospective cohort study was conducted at Koc, University Hospital from 1st January 2018 to 30th March 2022, during the COVID-19 pandemic. A total of 307 candidaemia isolates were obtained from 249 patients. A total of 272 episodes had monocandidaemia, while 16 episodes had poly-candidaemia. Antifungal susceptibility with broth microdilution with environmental microbiological sampling were obtained. Sequencing and amplification of the resistance genes with genotyping were carried out, and pulse field gel electrophoresis was performed in the isolates. Results: Of the 272 isolates that caused mono-candidaemia, 139 (51.1%) were identified as C. parapsilosis complex, with 64 (46%) demonstrating micafungin resistance. The isolates yielded Y132F mutation in the ERG11, and S656P mutation in the FKS1 genes, primarily genotypes A and A1. The 30-day mortality rates were 51.6% (33/64) for ECR C. parapsilosis complex, 38.9% (14/36) for fluconazole-resistant C. parapsilosis complex, and 35.9% (14/ 39) for fluconazole-susceptible C. parapsilosis complex. Environmental cultures showed that 23 of 60 samples yielded ECR C. parapsilosis complex, predominantly from interior parts and handles of infusion pumps used in oncology wards with a total clonal similarity with the clinical isolates. Conclusions: This is the first report of the FKS1S656P mutation in ECR C. parapsilosis complex isolates from Turkey, and it highlights a significant outbreak associated with an unnoticed gap in cleaning of the interior parts of infusion pumps. Enhanced cleaning protocols, combined with on-site feedback, resulted in no new cases within the next 2 months.
dc.identifier.doi10.1016/j.jhin.2025.10.013
dc.identifier.endpage155
dc.identifier.issn0195-6701
dc.identifier.issn1532-2939
dc.identifier.orcid0000-0002-4115-3914
dc.identifier.pmid41167425
dc.identifier.scopus2-s2.0-105022913671
dc.identifier.scopusqualityQ1
dc.identifier.startpage145
dc.identifier.urihttps://doi.org/10.1016/j.jhin.2025.10.013
dc.identifier.urihttps://hdl.handle.net/11616/109535
dc.identifier.volume167
dc.identifier.wosWOS:001631623900001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherW B Saunders Co Ltd
dc.relation.ispartofJournal of Hospital Infection
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_WOS_20250329
dc.subjectEchinocandin-resistant
dc.subjectMicafungin-resistant
dc.subjectCandida parapsilosis complex
dc.subjectOutbreak
dc.subjectCandidaemia
dc.subjectMono
dc.titleAnalysis of an outbreak of echinocandin-resistant clonal Candida parapsilosis complex harbouring ERG11Y132F and FKS1S656P mutations
dc.typeArticle

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