Association between CAI microsatellite, multilocus sequence typing, and clinical significance within Candida albicans isolates

Yen-Mu Wu; Chih-Hua Lee; Yi-Chuan Cheng; Jang-Jih Lu; Shao-Hung Wang

doi:10.1093/mmy/myaa090

Association between CAI microsatellite, multilocus sequence typing, and clinical significance within Candida albicans isolates

Med Mycol. 2021 May 4;59(5):498-504. doi: 10.1093/mmy/myaa090.

Authors

Yen-Mu Wu^{1

2}, Chih-Hua Lee³, Yi-Chuan Cheng⁴, Jang-Jih Lu^{3

5

6}, Shao-Hung Wang⁷

Affiliations

¹ Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
² Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
³ Department of Laboratory Medicine, Chang-Gung Memorial Hospital Linkou, Taoyuan, Taiwan.
⁴ Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁵ Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan.
⁶ Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
⁷ Department of Microbiology, Immunology and Biopharmaceuticals, National Chiayi University, Chiayi, Taiwan.

PMID: 33099643
DOI: 10.1093/mmy/myaa090

Abstract

Candida albicans bloodstream infection (BSI) is epidemiologically important because of its increasing frequency and serious outcome. Strain typing and delineation of the species are essential for understanding the phylogenetic relationship and clinical significance. Microsatellite CAI genotyping and multilocus sequence typing (MLST) were performed on 285 C. albicans bloodstream isolates from patients in Chang Gung Memorial Hospital at Linkou (CGMHL), Taiwan from 2003 to 2011. Data regarding demographics, comorbidities, risk factors, and clinical outcomes were recorded within adult patients with C. albicans BSI. Both CAI genotyping and MLST yielded comparable discriminatory power for C. albicans characterization. Besides, the distribution of CAI repetition showed a satisfactory phylogenetic association, which could be a good alternative method in the molecular phylogenetics of C. albicans and epidemiological studies. As for the clinical scenario, clade 17 isolates with CAI alleles either possessing 29 or more repetitions were related to higher 14-day and 30-day mortality, and shorter median survival days.

Keywords: Candida albicans; ClinProTools; MALDI-TOF MS; MLST; microsatellite CAI genotype; mortality.

MeSH terms

Aged
Aged, 80 and over
Alleles
Candida albicans / genetics*
Candida albicans / isolation & purification
Candidiasis / epidemiology
Candidiasis / microbiology*
Cluster Analysis
Female
Genotype
Humans
Male
Microsatellite Repeats*
Middle Aged
Molecular Epidemiology
Multilocus Sequence Typing
Mycological Typing Techniques
Phylogeny
Risk Factors
Sepsis / microbiology
Taiwan / epidemiology