The Journal of Practical Medicine >
Application value of nucleic acid mass spectrometry in detecting ERG11 mutation in Candida tropicalis
Received date: 2025-05-08
Online published: 2025-08-28
Objective To evaluate the application value of nucleic acid mass spectrometry in detecting ERG11 gene mutations associated with azole resistance in Candida tropicalis (C. tropicalis), thereby providing a scientific basis for the rational clinical use of azole antifungal agents. Methods Clinical isolates of C. tropicalis were obtained from the Affiliated Hospital of Xuzhou Medical University between July 2023 and November 2024. For each isolate, specific ERG11 mutations (A395T and C461T) were analyzed using Sanger sequencing and nucleic acid mass spectrometry. Sanger sequencing was used as the reference standard to evaluate the performance of mass spectrometry in mutation detection. Results The established nucleic acid mass spectrometry method effectively identified four genotypes of ERG11 (A395T and C461T), with distinct spectral peaks for each mutation and no cross-interference observed. Among 88 clinical isolates, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the A395T mutation were 86.7%, 100%, 100%, and 97.3%, respectively. For the C461T mutation, the corresponding values were 81.3%, 100%, 100%, and 96.0%, respectively. Kappa statistics demonstrated a high level of agreement between mass spectrometry and sequencing results. Conclusions Nucleic acid mass spectrometry exhibits high sensitivity and specificity in the detection of ERG11 mutations, enabling rapid, accurate, and adaptable high-throughput analysis. This makes it a highly effective method for identifying mutations associated with fungal resistance.
Yan CHEN , Hongxia ZHU , Haiquan KANG , Yi GUO , Yinhai XU , Jingfang. SUN . Application value of nucleic acid mass spectrometry in detecting ERG11 mutation in Candida tropicalis[J]. The Journal of Practical Medicine, 2025 , 41(16) : 2575 -2580 . DOI: 10.3969/j.issn.1006-5725.2025.16.020
| [1] | World Health Organization. WHO fungal priority pathogens list to guide research, development and public health action[R]. Geneva: WHO, 2022. |
| [2] | XIAO M, CHEN S C A, KONG F, et al. Distribution and antifungal susceptibility of Candida species causing candidemia in China: An update from the CHIF-NET study[J]. J Infect Dis, 2020, 221(): S139-S147. doi:10.1093/infdis/jiz573 |
| [3] | BILAL H, SHAFIQ M, HOU B, et al. Distribution and antifungal susceptibility pattern of Candida species from mainland China: A systematic analysis[J]. Virulence, 2022, 13(1): 1573-1589. doi:10.1080/21505594.2022.2123325 |
| [4] | WANG Y, FAN X, WANG H, et al. Continual decline in azole susceptibility rates in Candida tropicalis over a 9-year period in China[J]. Front Microbiol, 2021, 12: 702839. doi:10.3389/fmicb.2021.702839 |
| [5] | FAN X, XIAO M, ZHANG D, et al. Molecular mechanisms of azole resistance in Candida tropicalis isolates causing invasive candidiasis in China[J]. Clin Microbiol Infect, 2019, 25(7): 885-891. doi:10.1016/j.cmi.2018.11.007 |
| [6] | HU T, WANG S, BING J, et al. Hotspot mutations and genomic expansion of ERG11 are major mechanisms of azole resistance in environmental and human commensal isolates of Candida tropicalis[J]. Int J Antimicrob Agents, 2023, 62(6): 107010. doi:10.1016/j.ijantimicag.2023.107010 |
| [7] | FAN X, TSUI C K M, CHEN X, et al. High prevalence of fluconazole resistant Candida tropicalis among candiduria samples in China: An ignored matter of concern[J]. Front Microbiol, 2023, 14: 1125241. doi:10.3389/fmicb.2023.1125241 |
| [8] | EL-KHOLY M A, HELALY G F, GHAZZAWI E F EL, et al. Analysis of CDR1 and MDR1 gene expression and ERG11 substitutions in clinical Candida tropicalis isolates from Alexandria, Egypt[J]. Braz J Microbiol, 2023, 54(4): 2609-2615. doi:10.1007/s42770-023-01106-y |
| [9] | SIQUEIRA A C, BERNARDI G A, AREND L N V S, et al. Azole Resistance and ERG11 Mutation in Clinical Isolates of Candida tropicalis[J]. J Fungi (Basel), 2025, 11(1): 24. doi:10.3390/jof11010024 |
| [10] | FAN X, DAI R C, ZHANG S, et al. Tandem gene duplications contributed to high-level azole resistance in a rapidly expanding Candida tropicalis population[J]. Nat Commun, 2023, 14(1): 8369. doi:10.1038/s41467-023-43380-2 |
| [11] | PAUL S, SHAW D, JOSHI H, et al. Mechanisms of azole antifungal resistance in clinical isolates of Candida tropicalis[J]. PLoS One, 2022, 17(7): e0269721. doi:10.1371/journal.pone.0269721 |
| [12] | XIU L, ZHANG C, LI Y, et al. Simultaneous detection of eleven sexually transmitted agents using multiplexed PCR coupled with MALDI-TOF analysis[J]. Infect Drug Resist, 2019, 12: 2671-2682. doi:10.2147/idr.s219580 |
| [13] | YANG H, LI A, DANG L, et al. A rapid, accurate, and low-cost method for detecting Mycobacterium tuberculosis and its drug-resistant genes in pulmonary tuberculosis: Applications of MassARRAY DNA mass spectrometry[J]. Front Microbiol, 2023, 14: 1093745. doi:10.3389/fmicb.2023.1093745 |
| [14] | 余艳芳,赵开顺,屠春林,等.核酸质谱检测结核分枝杆菌耐药方法的建立[J].临床肺科杂志,2021,26(1):74-81. |
| [15] | 李爱芳,曹俊杰,雷静,等.核酸质谱在结核分枝杆菌耐药基因检测中的应用价值[J].中国热带医学,2024,24(12):1529-1533. |
| [16] | 梁建琴,吴雪琼,安慧茹.核酸基质辅助激光解吸电离飞行时间质谱技术在结核病和非结核分枝杆菌病诊断中的临床应用专家共识[J].中国防痨杂志,2023,45(6):543-558. |
| [17] | 李航逸,郭超敏,王成彬.核酸质谱技术检测常见念珠菌血症病原菌[J]. 中华检验医学杂志,2023,46(4):402-409. |
| [18] | WAN F, ZHANG M, GUO J, et al. A MALDI-TOF MS-based multiple detection panel of drug resistance-associated multiple single-nucleotide polymorphisms in Candida tropicalis[J]. Microbiol Spectrum, 2025, 13(1): e0076424. doi:10.1128/spectrum.00764-24 |
| [19] | Clinical And Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing: 34th ed. [S]. Wayne, PA: CLSI, 2024. |
| [20] | 范欣.中国多中心连续五年侵袭性感染热带念珠菌流行病学及唑类耐药机制研究[D].北京:北京协和医学院,2017. |
| [21] | ZHU Y C, HAGER K M, MANJARI S R, et al. Development and validation of TaqMan chemistry probe-based rapid assay for the detection of echinocandin-resistance in Candida auris[J]. J Clin Microbiol, 2023, 61(4): e0176722. doi:10.1128/jcm.01767-22 |
| [22] | PAUL S, DADWAL R, SINGH S, et al. Rapid detection of ERG11 polymorphism associated azole resistance in Candida tropicalis[J]. PLoS One, 2021, 16(1): e0245160. doi:10.1371/journal.pone.0245160 |
/
| 〈 |
|
〉 |