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MALDI-TOF MS Overcomes Misidentification of the Uncommon Human Pathogen Candida famata by Routine Phenotypic Identification Methods

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Abstract

Candida famata has been associated with the identifiable Candida infections that takes place in human and the identification error of this species possibly will result in misinterpretation of antifungal susceptibility and improper diagnosis; which will have a major effect on the prognosis and therapy of patients. Our objective is to correctly identify Candida spp. collected from patients at the intensive care units, New Cairo University teaching hospital in Cairo-Egypt using matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF MS). Hundred clinically isolated yeast strains were identified using API 20C AUX obtained from patients receiving care at intensive care units. ATB FUNGUS 3 strips were used to detect the minimum inhibitory concentration. Thirty-three non duplicate strains identified as C. famata were subjected to re-identification by MALDI-TOF MS. Our results revealed that isolates were initially identified as C. famata 33%, C. tropicalis 15%, C. albicans 12% and C. parapsillosis 10% using the phenotypic techniques. MALDI-TOF MS analyses results showed that the 33 C. famata isolates are C. tropicalis (n = 29), Trichosporon asahii (n = 2), C. parapsilosis (n = 1), and Aeromonas sobria (n = 1). Antifungal resistance was low in the Candida species, except for reduced susceptibility to itraconazole among C. krusei strains. This report shows that misidentification of C. famata is frequent when using conventional phenotypic methods of identification which result in challenges in treating fungal infections. MALDI-TOF MS is an accurate convenient substitute to classical approaches for fungal identification. In general, antifungal multidrug resistance is uncommon in our studied Candida species and yeast isolates.

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Acknowledgements

The authors extend their appreciation to the intensive care units at new Cairo university teaching hospital, Cairo, Egypt.

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Authors and Affiliations

  1. Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

    Doaa Ghaith & May AbdElfattah

  2. Department of Microbiology and Immunology, Faculty of Pharmacy, Ahram Canadian University, 4th Industrial Zone, Banks Complex, 6Th of October, Cairo, Egypt

    Mai M. Zafer

  3. Clinical and Chemical Pathology Department, Faculty of Medicine, Zagazig University, Sharkia, Egypt

    Thoraya Hosny

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  1. Doaa Ghaith
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  2. Mai M. Zafer
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  4. May AbdElfattah
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Contributions

Dr. DG, Dr. MMZ, Dr. TH and Dr. MA contributed to the study proposal, implementation of experiments, results evaluation and writing & editing of the manuscript.

Corresponding author

Correspondence to Mai M. Zafer.

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The authors declare that they have no conflict of interest.

Ethical Approval

The study was approved by the Ethical committee of the clinical and chemical pathology department of Cairo University Hospital as the yeast strains described in this paper are part of routine care for hospitalized intensive care units ‘patients.

Informed Consent

No additional clinical specimens were obtained for purposes of research; therefore, informed consent was not required.

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Ghaith, D., Zafer, M.M., Hosny, T. et al. MALDI-TOF MS Overcomes Misidentification of the Uncommon Human Pathogen Candida famata by Routine Phenotypic Identification Methods. Curr Microbiol 78, 1636–1642 (2021). https://doi.org/10.1007/s00284-021-02411-1

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  • DOI: https://doi.org/10.1007/s00284-021-02411-1