{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T01:23:25Z","timestamp":1779240205328,"version":"3.51.4"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T00:00:00Z","timestamp":1694131200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Backgrounds<\/jats:title><jats:p><jats:italic>Candida glabrata<\/jats:italic> is a frequently isolated non-<jats:italic>albicans Candida<\/jats:italic> species and invasive <jats:italic>C. glabrata<\/jats:italic> infections in older patients are associated with high mortality rates. Opportunistic <jats:italic>Candida<\/jats:italic> infections in critically ill patients may be either endogenous or nosocomial in origin and this distinction is critical for effective intervention strategies. This study performed multi-locus sequence typing (MLST) to study genotypic relatedness among clinical <jats:italic>C. glabrata<\/jats:italic> isolates in Kuwait.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:italic>Candida glabrata<\/jats:italic> isolates (<jats:italic>n<\/jats:italic>\u2009=\u200991) cultured from 91 patients were analyzed by MLST. Repeat isolates (<jats:italic>n<\/jats:italic>\u2009=\u200916) from 9 patients were also used. Antifungal susceptibility testing for fluconazole, voriconazole, caspofungin and amphotericin B (AMB) was determined by Etest. Genetic relatedness was determined by constructing phylogenetic tree and minimum spanning tree by using BioNumerics software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Resistance to fluconazole, voriconazole and AMB was detected in 7, 2 and 10 <jats:italic>C. glabrata<\/jats:italic> isolates, respectively. MLST identified 28 sequence types (STs), including 12 new STs. ST46 (<jats:italic>n<\/jats:italic>\u2009=\u200933), ST3 (<jats:italic>n<\/jats:italic>\u2009=\u20098), ST7 (<jats:italic>n<\/jats:italic>\u2009=\u20096) and ST55 (<jats:italic>n<\/jats:italic>\u2009=\u20096) were prevalent in \u22654 hospitals. Repeat isolates obtained from same or different site yielded identical ST. No association of ST46 with source of isolation or resistance to antifungals was apparent. Microevolution and cross-transmission of infection was indicated in two hospitals that yielded majority (57 of 91, 67%) of <jats:italic>C. glabrata<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our data suggest that <jats:italic>C. glabrata<\/jats:italic> undergoes microevolution in hospital environment and can be nosocomially transmitted to other susceptible patients. Thus, proper infection control practices during routine procedures on <jats:italic>C. glabrata<\/jats:italic>-infected patients may prevent transmission of this pathogen to other hospitalized patients.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1242622","type":"journal-article","created":{"date-parts":[[2023,9,8]],"date-time":"2023-09-08T12:21:20Z","timestamp":1694175680000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Molecular fingerprinting by multi-locus sequence typing identifies microevolution and nosocomial transmission of Candida glabrata in Kuwait"],"prefix":"10.3389","volume":"11","author":[{"given":"Mohammad","family":"Asadzadeh","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suhail","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noura","family":"Al-Sweih","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziauddin","family":"Khan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,9,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"165rv13","DOI":"10.1126\/scitranslmed.3004404","article-title":"Hidden killers: human fungal infections","volume":"4","author":"Brown","year":"2012","journal-title":"Sci Transl 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