The opportunistic pathogen Candida parapsilosis is a major causative agent of candidiasis leading to death in immunocompromised individuals. Azoles are the first line of defense in their treatment. The purpose of this study was to characterize eight fluconazole-resistant and sensitive C. parapsilosis hospital isolates through a battery of phenotypic tests that target pathogenicity attributes such as virulence, biofilm formation, stress resistance, and ergosterol content. Whole genome sequencing was carried out to identify mutations in key pathogenicity and resistance genes. Phylogenetic comparison was performed to determine strain relatedness and clonality. Genomic data and phylogenetic analysis revealed that two isolates were C. orthopsilosis and C. metapsilosis misidentified as C. parapsilosis. Whole genome sequencing analysis revealed known and novel mutations in key drug resistance and pathogenicity genes such as ALS6, ALS7, SAPP3, SAP7, SAP9, CDR1, ERG6, ERG11 and UPC2. Phylogenetic analysis revealed a high degree of relatedness and clonality within our C. parapsilosis isolates. Our results showed that resistant isolates exhibited an increase in biofilm content compared to the sensitive isolates. In conclusion, our study is the first of its kind in Lebanon to describe phenotypic and genotypic characteristics of nosocomial C. parapsilosis complex isolates having a remarkable ability to form biofilms.

Biomedical Center Faculty of Medicine Charles University Pilsen Czech Republic

Department of Biology Saint George University of Beirut Beirut Lebanon

Department of Microbiology Faculty of Medicine University Hospital in Pilsen Charles University Pilsen Czech Republic

Department of Natural Sciences Lebanese American University PO Box 36 Byblos Lebanon

Lebanese American University Medical Center Rizk Hospital Beirut Lebanon

School of Medicine Lebanese American University Beirut Lebanon

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Res Sq. 2024 May 30:rs.3.rs-4169036. doi: 10.21203/rs.3.rs-4169036/v1. PubMed

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