Antifungal Drug Susceptibility and Genetic Characterization of Fungi Recovered from COVID-19 Patients

Journal of Fungi

David S. Perlin¹  Rocio Garcia-Rubio¹  Cristina Jiménez-Ortigosa¹  Milena Kordalewska¹  José R. Mediavilla¹  Marcus H. Cunningham¹  Barry N. Kreiswirth¹  Kevin D. Guerrero¹  Kar Fai Chow²  Tao Hong²  Frank Hollis² 

[1] Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA;Hackensack University Medical Center, Hackensack, NJ 07601, USA;

关键词: Candida albicans;    Candida parapsilosis;    Aspergillus fumigatus;    antifungal susceptibility;    secondary infections;    Candida pneumonia;   

DOI  :  10.3390/jof7070552

来源: DOAJ

【 摘 要 】

Fungal infections are common complications of respiratory viral infections and are associated with the increased need for intensive care and elevated mortality. Data regarding microbiological and molecular characteristics of such infections in COVID-19 patients are scarce. Here, we performed a comprehensive analysis, including species identification, antifungal susceptibility testing, molecular resistance determinants analysis, typing, and retrospective clinical data review, of fungal isolates recovered from 19 COVID-19 patients, who were hospitalized at the Hackensack University Medical Center (HUMC) in Hackensack, New Jersey, USA, in the initial phase of the pandemic from April–May 2020. In total, 17 Candida albicans, two C. parapsilosis, and two Aspergillus fumigatus were analyzed. All Candida spp. isolates were susceptible to micafungin and azole drugs (fluconazole, voriconazole, posaconazole, itraconazole, isavuconazole). A. fumigatus isolates were susceptible to micafungin and all triazole drugs except fluconazole (intrinsic resistance). Multilocus sequence typing (MLST) of C. albicans isolates revealed 15 different sequence types (STs), which clustered below the clade-defining limit of p-distance < 0.04. Pulsed-field gel electrophoresis (PFGE) karyotyping revealed no chromosomal rearrangements in these isolates. A. fumigatus isolates were of different, non-related genotypes. We speculate that virus- and drug-induced immunosuppression (94.7% of the patients received corticosteroids), together with prolonged hospital stay (median duration of 29 days) and mechanical ventilation (median duration of 24 days) likely increased the susceptibility to secondary respiratory and bloodstream infections in the studied patient population. The presence of fungi in blood or respiratory tract fluid was a prognosticator for poor clinical outcome, which presented as an 89.5% 30-day mortality in our patient cohort.

【 授权许可】

Unknown