{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T04:24:28Z","timestamp":1790223868150,"version":"4.1.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2019,3,15]],"date-time":"2019-03-15T00:00:00Z","timestamp":1552608000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We aim to assess intra- and interspecies differences in the virulence of Candida spp. strains causing candidemia using the invertebrate Galleria mellonella model. We studied 739 Candida spp. isolates (C. albicans [n = 373], C. parapsilosis [n = 203], C. glabrata [n = 92], C. tropicalis [n = 53], and C. krusei [n = 18]) collected from patients with candidemia admitted to Gregorio Mara\u00f1on Hospital (Madrid, Spain). Species-specific infecting inocula (yeast cells\/larva) were adjusted (5 \u00d7 105 [C. albicans, and C. tropicalis], 2 \u00d7 106\u20135 \u00d7 106 [C. parapsilosis, C. glabrata, and C. krusei]) and used to infect 10 larvae per isolate; percentage of survival and median survival per isolate were calculated. According to the interquartile range of the median survival, isolates with a median survival under P25 were classified as of high-virulence and isolates with a median survival over P75 as of low virulence. The median survival of larvae infected with different species was variable: C. albicans (n = 2 days, IQR &amp;lt;1\u22123 days), C. tropicalis (n = 2 days, IQR 1.5\u22124 days), C. parapsilosis (n = 2 days, IQR 2\u22123.5 days), C. glabrata (n = 3 days, IQR 2\u22123 days), and C. krusei (n = 7 days, 6.5\u2212&amp;gt;8 days) (P &amp;lt; .001). Differences in virulence among species were validated by histological examination (day +1 post-infection) in the larvae infected by the isolates of each virulence category and species. Virulence-related gene expression in C. albicans isolates did not reach statistical significance. We report species-specific virulence patterns of Candida spp. and show that isolates within a given species have different degrees of virulence in the animal model.<\/jats:p>","DOI":"10.1093\/mmy\/myz027","type":"journal-article","created":{"date-parts":[[2019,2,22]],"date-time":"2019-02-22T12:27:38Z","timestamp":1550838458000},"page":"83-92","source":"Crossref","is-referenced-by-count":23,"title":["Candida isolates causing candidemia show different degrees of virulence in Galleria mellonella"],"prefix":"10.1093","volume":"58","author":[{"given":"Laura Judith","family":"Marcos-Zambrano","sequence":"first","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda \u00c1ngeles","family":"Bordallo-Cardona","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa","family":"Borghi","sequence":"additional","affiliation":[{"name":"Laboratory of Microbiology, Department of Health Sciences. Universit\u00e0 degli Studi di Milano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Falleni","sequence":"additional","affiliation":[{"name":"Division of Human Pathology, Department of Health Sciences, Universit\u00e0 degli Studi di Milano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delfina","family":"Tosi","sequence":"additional","affiliation":[{"name":"Division of Human Pathology, Department of Health Sciences, Universit\u00e0 degli Studi di Milano, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"CIBER Enfermedades Respiratorias-CIBERES (CD06\/06\/0058), Madrid, Spain"},{"name":"Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pilar","family":"Escribano","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Guinea","sequence":"additional","affiliation":[{"name":"Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n, Madrid, Spain"},{"name":"CIBER Enfermedades Respiratorias-CIBERES (CD06\/06\/0058), Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,3,15]]},"reference":[{"key":"2020010209375524100_bib1","doi-asserted-by":"crossref","first-page":"1829","DOI":"10.1128\/JCM.43.4.1829-1835.2005","article-title":"Epidemiology and predictors of mortality in cases of Candida bloodstream infection: results from population-based surveillance, Barcelona, Spain, from 2002 to 2003","volume":"43","author":"Almirante","year":"2005","journal-title":"J Clin Microbiol"},{"key":"2020010209375524100_bib2","doi-asserted-by":"crossref","first-page":"O245","DOI":"10.1111\/1469-0691.12380","article-title":"Epidemiology and predictive factors for early and late mortality in Candida bloodstream infections: a population-based surveillance in Spain","volume":"20","author":"Puig-Asensio","year":"2014","journal-title":"Clin Microbiol Infect"},{"key":"2020010209375524100_bib3","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/1469-0691.12539","article-title":"Global trends in the distribution of Candida species causing candidemia","volume":"20","author":"Guinea","year":"2014","journal-title":"Clin Microbiol Infect"},{"key":"2020010209375524100_bib4","doi-asserted-by":"crossref","first-page":"839","DOI":"10.3109\/13693780903580121","article-title":"Five-year evaluation of bloodstream yeast infections in a tertiary hospital: the predominance of non-C. albicans Candida species","volume":"48","author":"Pereira","year":"2010","journal-title":"Med Mycol"},{"key":"2020010209375524100_bib5","doi-asserted-by":"crossref","first-page":"461","DOI":"10.3109\/13693786.2012.737031","article-title":"The non-mammalian host Galleria mellonella can be used to study the virulence of the fungal pathogen Candida tropicalis and the efficacy of antifungal drugs during infection by this pathogenic yeast","volume":"51","author":"Mesa-Arango","year":"2013","journal-title":"Med Mycol"},{"key":"2020010209375524100_bib6","doi-asserted-by":"crossref","first-page":"857","DOI":"10.3855\/jidc.5359","article-title":"Investigation of the relationship between virulence factors and genotype of Candida spp. isolated from blood cultures","volume":"9","author":"Mutlu Sariguzel","year":"2015","journal-title":"J Infect Dev Ctries"},{"key":"2020010209375524100_bib7","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1128\/EC.00062-15","article-title":"Characterization of virulence-related phenotypes in Candida species of the CUG Clade","volume":"14","author":"Priest","year":"2015","journal-title":"Eukaryot Cell"},{"key":"2020010209375524100_bib8","doi-asserted-by":"crossref","first-page":"119","DOI":"10.4161\/viru.22913","article-title":"Candida albicans pathogenicity mechanisms","volume":"4","author":"Mayer","year":"2013","journal-title":"Virulence"},{"key":"2020010209375524100_bib9","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/s12275-016-5514-0","article-title":"Interaction of Candida albicans with host cells: virulence factors, host defense, escape strategies, and the microbiota","volume":"54","author":"Hofs","year":"2016","journal-title":"J Microbiol"},{"key":"2020010209375524100_bib10","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1080\/21505594.2015.1012981","article-title":"Candida albicans-epithelial interactions and pathogenicity mechanisms: scratching the surface","volume":"6","author":"Moyes","year":"2015","journal-title":"Virulence"},{"key":"2020010209375524100_bib11","first-page":"3","article-title":"Adherence of Candida sp. to host tissues and cells as one of its pathogenicity features","volume":"61","author":"Modrzewska","year":"2015","journal-title":"Ann Parasitol"},{"key":"2020010209375524100_bib12","doi-asserted-by":"crossref","first-page":"280","DOI":"10.3389\/fmicb.2016.00280","article-title":"Candida albicans agglutinin-like sequence (Als) family vignettes: a review of Als protein structure and function","volume":"7","author":"Hoyer","year":"2016","journal-title":"Front Microbiol"},{"key":"2020010209375524100_bib13","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1111\/j.1574-695X.2002.tb00617.x","article-title":"Correlation between virulence of Candida albicans mutants in mice and Galleria mellonella larvae","volume":"34","author":"Brennan","year":"2002","journal-title":"FEMS Immunol Med Microbiol"},{"key":"2020010209375524100_bib14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.mycmed.2015.12.006","article-title":"Pathogenicity of Candida albicans isolates from bloodstream and mucosal candidiasis assessed in mice and Galleria mellonella","volume":"26","author":"Frenkel","year":"2016","journal-title":"J Mycol Med"},{"key":"2020010209375524100_bib15","doi-asserted-by":"crossref","first-page":"237","DOI":"10.4161\/viru.27434","article-title":"Galleria mellonella as a model host to study virulence of Candida","volume":"5","author":"Jacobsen","year":"2014","journal-title":"Virulence"},{"key":"2020010209375524100_bib16","doi-asserted-by":"crossref","first-page":"597","DOI":"10.4161\/viru.25906","article-title":"An analysis of the structural and functional similarities of insect hemocytes and mammalian phagocytes","volume":"4","author":"Browne","year":"2013","journal-title":"Virulence"},{"key":"2020010209375524100_bib17","doi-asserted-by":"crossref","first-page":"475","DOI":"10.4161\/viru.1.6.12985","article-title":"Methods for using Galleria mellonella as a model host to study fungal pathogenesis","volume":"1","author":"Fuchs","year":"2010","journal-title":"Virulence"},{"key":"2020010209375524100_bib18","first-page":"322","article-title":"Amplification and direct sequencing of fungal ribosomal RNA genes for phylogenetics","volume-title":"PCR Protocols: A Guide to Methods and Applications","author":"White","year":"1990"},{"key":"2020010209375524100_bib19","doi-asserted-by":"crossref","first-page":"1482","DOI":"10.1248\/bpb.b13-00270","article-title":"Using Galleria mellonella-Candida albicans infection model to evaluate antifungal agents","volume":"36","author":"Li","year":"2013","journal-title":"Biol Pharm Bull"},{"key":"2020010209375524100_bib20","doi-asserted-by":"crossref","first-page":"278","DOI":"10.4161\/viru.26973","article-title":"Candida parapsilosis, Candida orthopsilosis, and Candida metapsilosis virulence in the non-conventional host Galleria mellonella","volume":"5","author":"Gago","year":"2014","journal-title":"Virulence"},{"key":"2020010209375524100_bib21","doi-asserted-by":"crossref","first-page":"e60047","DOI":"10.1371\/journal.pone.0060047","article-title":"Antifungal efficacy during Candida krusei infection in non-conventional models correlates with the yeast in vitro susceptibility profile","volume":"8","author":"Scorzoni","year":"2013","journal-title":"PLoS One"},{"key":"2020010209375524100_bib22","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1179\/1973947813Y.0000000100","article-title":"Antifungal resistance does not necessarily affect Candida glabrata fitness","volume":"26","author":"Borghi","year":"2014","journal-title":"J Chemother"},{"key":"2020010209375524100_bib23","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1080\/08927014.2015.1125472","article-title":"Modulation of Candida albicans virulence by bacterial biofilms on titanium surfaces","volume":"32","author":"Cavalcanti","year":"2016","journal-title":"Biofouling"},{"key":"2020010209375524100_bib24","doi-asserted-by":"crossref","first-page":"4839","DOI":"10.1128\/IAI.00248-10","article-title":"Limited role of secreted aspartyl proteinases Sap1 to Sap6 in Candida albicans virulence and host immune response in murine hematogenously disseminated candidiasis","volume":"78","author":"Correia","year":"2010","journal-title":"Infect Immun"},{"key":"2020010209375524100_bib25","first-page":"589","article-title":"Expression analysis of SIR2 and SAPs1-4 gene expression in Candida albicans treated with allicin compared to fluconazole","volume":"28","author":"Khodavandi","year":"2011","journal-title":"Trop Biomed"},{"key":"2020010209375524100_bib26","doi-asserted-by":"crossref","first-page":"2428","DOI":"10.4081\/ejh.2014.2428","article-title":"A histological procedure to study fungal infection in the wax moth Galleria mellonella","volume":"58","author":"Perdoni","year":"2014","journal-title":"Eur J Histochem"},{"key":"2020010209375524100_bib27","doi-asserted-by":"crossref","first-page":"1192","DOI":"10.1016\/j.ijmm.2014.08.012","article-title":"Production of biofilm by Candida and non-Candida spp. isolates causing fungemia: comparison of biomass production and metabolic activity and development of cut-off points","volume":"304","author":"Marcos-Zambrano","year":"2014","journal-title":"Int J Med Microbiol"},{"key":"2020010209375524100_bib28","article-title":"Growth kinetics in Candida spp.: Differences between species and potential impact on antifungal susceptibility testing as described by the EUCAST","author":"Bordallo-Cardona","year":"2018","journal-title":"Med Mycol"},{"key":"2020010209375524100_bib29","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1007\/s15010-002-2131-0","article-title":"In vivo pathogenicity of eight medically relevant Candida species in an animal model","volume":"30","author":"Arendrup","year":"2002","journal-title":"Infection"},{"key":"2020010209375524100_bib30","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1016\/j.mycmed.2018.04.009","article-title":"Comparative analysis of proteinase, phospholipase, hydrophobicity and biofilm forming ability in Candida species isolated from clinical specimens","volume":"28","author":"Dabiri","year":"2018","journal-title":"J Mycol Med"},{"key":"2020010209375524100_bib31","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.jinf.2015.05.009","article-title":"Candida tropicalis bloodstream infection: Incidence, risk factors and outcome in a population-based surveillance","volume":"71","author":"Fernandez-Ruiz","year":"2015","journal-title":"J Infect"},{"key":"2020010209375524100_bib32","doi-asserted-by":"crossref","first-page":"O245","DOI":"10.1111\/1469-0691.12380","article-title":"Epidemiology and predictive factors for early and late mortality in Candida bloodstream infections: a population-based surveillance in Spain","volume":"20","author":"Puig-Asensio","year":"2014","journal-title":"Clin Microbiol Infect"},{"key":"2020010209375524100_bib33","doi-asserted-by":"crossref","first-page":"163","DOI":"10.2217\/fmb.13.159","article-title":"Correlation between Candida albicans biofilm formation and invasion of the invertebrate host Galleria mellonella","volume":"9","author":"Borghi","year":"2014","journal-title":"Future Microbiol"},{"key":"2020010209375524100_bib34","doi-asserted-by":"crossref","first-page":"799","DOI":"10.2217\/fmb.13.36","article-title":"Experimental biofilm-related Candida infections","volume":"8","author":"Cirasola","year":"2013","journal-title":"Future Microbiol"},{"key":"2020010209375524100_bib35","doi-asserted-by":"crossref","first-page":"e33705","DOI":"10.1371\/journal.pone.0033705","article-title":"Risk factors and outcomes of candidemia caused by biofilm-forming isolates in a tertiary care hospital","volume":"7","author":"Tumbarello","year":"2012","journal-title":"PLoS One"},{"key":"2020010209375524100_bib36","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.cmi.2015.09.018","article-title":"Biofilm formation is a risk factor for mortality in patients with Candida albicans bloodstream infection-Scotland, 2012\u20132013","volume":"22","author":"Rajendran","year":"2016","journal-title":"Clin Microbiol Infect"},{"key":"2020010209375524100_bib37","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1016\/j.cmi.2018.01.022","article-title":"Is biofilm production a prognostic marker in adults with candidaemia","volume":"24","author":"Munoz","year":"2018","journal-title":"Clin Microbiol Infect"},{"key":"2020010209375524100_bib38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/myc.12095","article-title":"Aspartic proteinases of Candida spp.: role in pathogenicity and antifungal resistance","volume":"57","author":"Silva","year":"2014","journal-title":"Mycoses"}],"container-title":["Medical Mycology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/mmy\/article-pdf\/58\/1\/83\/31677490\/myz027.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/mmy\/article-pdf\/58\/1\/83\/31677490\/myz027.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,1,2]],"date-time":"2020-01-02T14:38:05Z","timestamp":1577975885000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/mmy\/article\/58\/1\/83\/5381571"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,15]]},"references-count":38,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2019,3,15]]},"published-print":{"date-parts":[[2020,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/mmy\/myz027","relation":{},"ISSN":["1369-3786","1460-2709"],"issn-type":[{"value":"1369-3786","type":"print"},{"value":"1460-2709","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,1]]},"published":{"date-parts":[[2019,3,15]]}}}