Exponential Clonal Expansion of 5-Fluorocytosine–Resistant Candida tropicalis and New Insights into Underlying Molecular Mechanisms

In 2022, we initiated systematic 5-fluorocytosine susceptibility testing of Candida spp. isolates in Denmark; we observed a bimodal MIC distribution in C. tropicalis, with MICs >16 mg/L in half the isolates. This study investigates the epidemiology and molecular mechanisms of 5-fluorocytosine re...

Full description

Saved in:
Bibliographic Details
Main Authors: Nissrine Abou-Chakra, Karen Marie Thyssen Astvad, Jan Martinussen, Amalie Sofie Eilsø Munksgaard, Maiken Cavling Arendrup
Format: Article
Language:English
Published: Centers for Disease Control and Prevention 2025-05-01
Series:Emerging Infectious Diseases
Subjects:
Online Access:https://wwwnc.cdc.gov/eid/article/31/5/24-1910_article
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849697557722169344
author Nissrine Abou-Chakra
Karen Marie Thyssen Astvad
Jan Martinussen
Amalie Sofie Eilsø Munksgaard
Maiken Cavling Arendrup
author_facet Nissrine Abou-Chakra
Karen Marie Thyssen Astvad
Jan Martinussen
Amalie Sofie Eilsø Munksgaard
Maiken Cavling Arendrup
author_sort Nissrine Abou-Chakra
collection DOAJ
description In 2022, we initiated systematic 5-fluorocytosine susceptibility testing of Candida spp. isolates in Denmark; we observed a bimodal MIC distribution in C. tropicalis, with MICs >16 mg/L in half the isolates. This study investigates the epidemiology and molecular mechanisms of 5-fluorocytosine resistance in C. tropicalis. We analyzed 104 C. tropicalis isolates from 3 time periods, alongside 353 C. albicans and 227 C. glabrata isolates from 2022. We determined MICs using EUCAST E.Def 7.3. Sequencing of FCY2 (purine-cytosine permease), FCY1 (cytosine deaminase), FUR1 (uracil phosphoribosyl transferase), and URA3 (orotidine-5′-phosphate decarboxylase) genes revealed FCY2 alterations—E49X (30/32), Q7X (1/32), and K6NfsX10 (1/32)—in resistant C. tropicalis strains. We found a URA3 alteration, K177E, in both susceptible and resistant strains. Microsatellite genotyping showed that all C. tropicalis isolates with E49X were clonally related. The marked increase in resistance, driven by the clonal spread of E49X, necessitates further research into virulence and environmental factors.
format Article
id doaj-art-35e35e1e95464e1981ce5b3e1239d5c4
institution DOAJ
issn 1080-6040
1080-6059
language English
publishDate 2025-05-01
publisher Centers for Disease Control and Prevention
record_format Article
series Emerging Infectious Diseases
spelling doaj-art-35e35e1e95464e1981ce5b3e1239d5c42025-08-20T03:19:11ZengCenters for Disease Control and PreventionEmerging Infectious Diseases1080-60401080-60592025-05-0131597798510.3201/eid3105.241910Exponential Clonal Expansion of 5-Fluorocytosine–Resistant Candida tropicalis and New Insights into Underlying Molecular MechanismsNissrine Abou-ChakraKaren Marie Thyssen AstvadJan MartinussenAmalie Sofie Eilsø MunksgaardMaiken Cavling Arendrup In 2022, we initiated systematic 5-fluorocytosine susceptibility testing of Candida spp. isolates in Denmark; we observed a bimodal MIC distribution in C. tropicalis, with MICs >16 mg/L in half the isolates. This study investigates the epidemiology and molecular mechanisms of 5-fluorocytosine resistance in C. tropicalis. We analyzed 104 C. tropicalis isolates from 3 time periods, alongside 353 C. albicans and 227 C. glabrata isolates from 2022. We determined MICs using EUCAST E.Def 7.3. Sequencing of FCY2 (purine-cytosine permease), FCY1 (cytosine deaminase), FUR1 (uracil phosphoribosyl transferase), and URA3 (orotidine-5′-phosphate decarboxylase) genes revealed FCY2 alterations—E49X (30/32), Q7X (1/32), and K6NfsX10 (1/32)—in resistant C. tropicalis strains. We found a URA3 alteration, K177E, in both susceptible and resistant strains. Microsatellite genotyping showed that all C. tropicalis isolates with E49X were clonally related. The marked increase in resistance, driven by the clonal spread of E49X, necessitates further research into virulence and environmental factors. https://wwwnc.cdc.gov/eid/article/31/5/24-1910_articleantimicrobial resistancefungiflucytosine resistanceCandida tropicalisclonal spreademerging resistance
spellingShingle Nissrine Abou-Chakra
Karen Marie Thyssen Astvad
Jan Martinussen
Amalie Sofie Eilsø Munksgaard
Maiken Cavling Arendrup
Exponential Clonal Expansion of 5-Fluorocytosine–Resistant Candida tropicalis and New Insights into Underlying Molecular Mechanisms
Emerging Infectious Diseases
antimicrobial resistance
fungi
flucytosine resistance
Candida tropicalis
clonal spread
emerging resistance
title Exponential Clonal Expansion of 5-Fluorocytosine–Resistant Candida tropicalis and New Insights into Underlying Molecular Mechanisms
title_full Exponential Clonal Expansion of 5-Fluorocytosine–Resistant Candida tropicalis and New Insights into Underlying Molecular Mechanisms
title_fullStr Exponential Clonal Expansion of 5-Fluorocytosine–Resistant Candida tropicalis and New Insights into Underlying Molecular Mechanisms
title_full_unstemmed Exponential Clonal Expansion of 5-Fluorocytosine–Resistant Candida tropicalis and New Insights into Underlying Molecular Mechanisms
title_short Exponential Clonal Expansion of 5-Fluorocytosine–Resistant Candida tropicalis and New Insights into Underlying Molecular Mechanisms
title_sort exponential clonal expansion of 5 fluorocytosine resistant candida tropicalis and new insights into underlying molecular mechanisms
topic antimicrobial resistance
fungi
flucytosine resistance
Candida tropicalis
clonal spread
emerging resistance
url https://wwwnc.cdc.gov/eid/article/31/5/24-1910_article
work_keys_str_mv AT nissrineabouchakra exponentialclonalexpansionof5fluorocytosineresistantcandidatropicalisandnewinsightsintounderlyingmolecularmechanisms
AT karenmariethyssenastvad exponentialclonalexpansionof5fluorocytosineresistantcandidatropicalisandnewinsightsintounderlyingmolecularmechanisms
AT janmartinussen exponentialclonalexpansionof5fluorocytosineresistantcandidatropicalisandnewinsightsintounderlyingmolecularmechanisms
AT amaliesofieeilsømunksgaard exponentialclonalexpansionof5fluorocytosineresistantcandidatropicalisandnewinsightsintounderlyingmolecularmechanisms
AT maikencavlingarendrup exponentialclonalexpansionof5fluorocytosineresistantcandidatropicalisandnewinsightsintounderlyingmolecularmechanisms