Common underlying conditions among patients yielding <i>C</i>. <i>tropicalis</i> isolates.

<p>Common underlying conditions among patients yielding <i>C</i>. <i>tropicalis</i> isolates.</p

An UPGMA-derived dendrogram based on allelic profile of 6 gene fragments from 63 <i>C</i>. <i>tropicalis</i> isolate from Kuwait.

<p>Similarity is presented in percentages using the scale bar in the upper left corner. The columns from left to right include, isolate number, MLST-based diploid sequence type (DST), clinical specimen yielding the isolate, data of isolation, hospital ward/unit where the patients were housed and eBURST group. Repeat isolates from the same patient are indicated by alphabets within brackets and DSTs for cluster isolates are shown by an asterisk (*) before the DST.</p

Clinical and epidemiological characteristics of patients yielding <i>C</i>. <i>tropicalis</i> isolates belonging to the three MLST-based clusters.

<p>Clinical and epidemiological characteristics of patients yielding <i>C</i>. <i>tropicalis</i> isolates belonging to the three MLST-based clusters.</p

Minimum spanning tree showing relationship of 63 <i>C</i>. <i>tropicalis</i> isolates from Kuwait with 804 isolates from other countries available from the MLST website as of January 2017.

<p>Each circle corresponds to a unique genotype, and lines between circles represent relative distance between isolates. The sizes of the circles correspond to the number of isolates of the same genotype (DST). Connecting lines correspond to the number of allele differences between genotypes, with a solid thick line connecting genotypes that differ in one locus, a solid thin line connecting genotypes that differ in two-three loci, a dashed line connecting genotypes that differ in four loci, and a dotted line connecting genotypes that differ in more than four loci.</p

Population structure and molecular genetic characterization of clinical <i>Candida tropicalis</i> isolates from a tertiary-care hospital in Kuwait reveal infections with unique strains

<div><p><i>Candida tropicalis</i> is a frequently isolated yeast species causing bloodstream, urinary tract and other infections particularly in patients admitted to intensive care units (ICUs) and those requiring prolonged urinary catheterization (UC) or receiving broad-spectrum antibiotics (BSA). This study investigated clinical characteristics and genetic relatedness among <i>C</i>. <i>tropicalis</i> strains isolated from patients at Al-Amiri Hospital in Kuwait. <i>C</i>. <i>tropicalis</i> strains (n = 63) isolated from blood, genito-urinary, respiratory (RT) and digestive (GIT) tracts and wound sites from 54 patients were used. All isolates were phenotypically identified and tested against six antifungal drugs by using Vitek 2 system. Molecular identification was performed by PCR amplification of rDNA. Fingerprinting was achieved by 6-loci-based multilocus sequence typing (MLST) and data were analyzed by BioNumerics software for phylogenetic relationships. Patients mean age was >65 years and >20% patients were hospitalized in ICUs. Most patients had underlying conditions that included UC, BSA, diabetes and RT/GIT abnormalities. Most candiduria cases had UC, ureteric stent or suprapubic catheters. All isolates were identified as <i>C</i>. <i>tropicalis</i> by Vitek 2 and by species-specific PCR. Sixty-two isolates were susceptible to all tested antifungal drugs. MLST identified 59 diploid sequence types (DSTs) including 54 newly-identified DSTs. <i>C</i>. <i>tropicalis</i> isolates from multiple sites of same patient usually belonged to different DSTs. Interestingly, 56 of 57 isolates from 48 patients belonged to unique genotypes. Only six isolates from six patients belonged to three DSTs (clusters), however, <i>C</i>. <i>tropicalis</i> strains in each cluster were isolated >3 months apart. Our data show diverse origins of <i>C</i>. <i>tropicalis</i> infections in Kuwait as most isolates were unique strains. There was no obvious correlation between cluster isolates with time of isolation and/or hospital ward of their origin. This study presents the first MLST analysis of <i>C</i>. <i>tropicalis</i> isolates from Middle East and may be useful for studying genetic relationships among global <i>C</i>. <i>tropicalis</i> strains.</p></div

MLST data for multiple <i>C</i>. <i>tropicalis</i> isolates from different anatomic sites of seven patients.

<p>MLST data for multiple <i>C</i>. <i>tropicalis</i> isolates from different anatomic sites of seven patients.</p