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Journal of Clinical Microbiology, June 2006, p. 2172-2178, Vol. 44, No. 6
0095-1137/06/$08.00+0     doi:10.1128/JCM.00320-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.

Multilocus Sequence Typing for Analyses of Clonality of Candida albicans Strains in Taiwan

Kuo-Wei Chen,1 Yee-Chun Chen,2 Hsiu-Jung Lo,3 Frank C. Odds,4 Tzu-Hui Wang,1 Chi-Yang Lin,1 and Shu-Ying Li1*

Laboratory for Mycology, Division of Research and Diagnostics, Center for Disease Control, Taipei, Taiwan,1 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan,2 Division of Clinical Research, National Health Research Institutes, Taipei, Taiwan,3 Aberdeen Fungal Group, Institute of Medical Sciences, University of Aberdeen, Aberdeen AB25 2ZD, United Kingdom4

Received 14 February 2006/ Returned for modification 22 March 2006/ Accepted 1 April 2006

Multilocus sequence typing (MLST) was used to characterize the genetic profiles of 51 Candida albicans isolates collected from 12 hospitals in Taiwan. Among the 51 isolates, 16 were epidemiologically unrelated, 28 were isolates from 11 critically ill, human immunodeficiency virus (HIV)-negative patients, and 7 were long-term serial isolates from 3 HIV-positive patients. Internal regions of seven housekeeping genes were sequenced. A total of 83 polymorphic nucleotide sites were identified. Ten to 20 different genotypes were observed at the different loci, resulting, when combined, in 45 unique genotype combinations or diploid sequence types (DSTs). Thirty (36.1%) of the 83 individual changes were synonymous and 53 (63.9%) were nonsynonymous. Due to the diploid nature of C. albicans, MLST was more discriminatory than the pulsed-field gel electrophoresis-BssHII-restricted fragment method in discriminating epidemiologically related strains. MLST is able to trace the microevolution over time of C. albicans isolates in the same patient. All but one of the DSTs of our Taiwanese strain collections were novel to the internet C. albicans DST database (http://test1.mlst.net/). The DSTs of C. albicans in Taiwan were analyzed together with those of the reference strains and of the strains from the United Kingdom and United States by unweighted-pair group method using average linkages and minimum spanning tree. Our result showed that the DNA type of each isolate was patient specific and associated with ABC type and decade of isolation but not associated with mating type, anatomical source of isolation, hospital origin, or fluconazole resistance patterns.

* Corresponding author. Mailing address: Laboratory for Mycology, Division of Research and Diagnostics, Center for Disease Control, No. 161, Kun-Yang Street, Taipei, Taiwan. Phone: 886 2 26531388. Fax: 886 2 26513572. E-mail: syl{at}cdc.gov.tw.

Journal of Clinical Microbiology, June 2006, p. 2172-2178, Vol. 44, No. 6
0095-1137/06/$08.00+0     doi:10.1128/JCM.00320-06
Copyright © 2006, American Society for Microbiology. All Rights Reserved.



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