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Evidence for a general-purpose genotype in Candida albicans , highly prevalent in multiple geographical regions, patient types and types of infection

Institute of Molecular BioSciences, Massey University, Palmerston North, New Zealand¹
Public Health Laboratory, Countess of Chester Health Park, Chester , UK²
Department of Oral Sciences and Orthodontics, University of Otago , New Zealand³
Faculty of Allied Health Sciences, Universiti Kebangsaan Malaysia , Malaysia⁴
Microbiology Division, Wellington Hospital, Wellington, New Zealand⁵
Microbiology Department, Auckland Hospital, Auckland, New Zealand⁶
Microbiology Unit, Canterbury Health Laboratories, Christchurch , New Zealand⁷
Medlab South Ltd, Christchurch, New Zealand⁸
Corporacion para Investigaciones Biologicas, Medellin, Colombia ⁹
Department of Pathology, CWM Hospital, Suva, Fiji ¹⁰

Author for correspondence: Jan Schmid. Tel: +64 6 350 4018. Fax: +64 6 350 5637. e-mail: J.Schmid{at}massey.ac.nz

Epidemiological studies, using the probe Ca3, have shown that in a given patient population a single cluster of genetically related Candida albicans isolates usually predominates. The authors have investigated whether these local clusters are part of a single group, geographically widespread and highly prevalent as an aetiological agent of various types of candidiasis. An unrooted neighbour-joining tree of 266 infection-causing C. albicans isolates (each from a different individual) from 12 geographical regions in 6 countries was created, based on genetic distances generated by Ca3 fingerprinting. Thirty-seven per cent of all isolates formed a single genetically homogeneous cluster (cluster A). The remainder of isolates were genetically diverse. Using the maximum branch length within cluster A as a cut-off, they could be divided into 37 groups, whose prevalence ranged between 0·3% and 9%. Strains from cluster A were highly prevalent in all but one geographical region, with a mean prevalence across all regions of 41%. When isolates were separated into groups based on patient characteristics or type of infection, strains from cluster A had a prevalence exceeding 27% in each group, and their mean prevalence was 43% across all patient characteristics. These data provide evidence that cluster A constitutes a general-purpose genotype, which is geographically widespread and acts as a predominant aetiological agent of all forms of candidiasis in all categories of patients surveyed.

Keywords: Candida albicans, pathogenesis, evolution, general-purpose genotype, Ca3 fingerprinting

Abbreviations: UPGMA, unweighted pair group method using arithmetic averages

^a Present address: Southern Community Laboratories, Christchurch, New Zealand.

^b Present address: Universal Diagnostic Laboratories, Fairfield, Australia.

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