Antifungal susceptibilities of Candida glabrata species complex, Candida krusei, Candida parapsilosis species complex and Candida tropicalis causing invasive candidiasis in China: 3 year national surveillance
Objectives: To define the antifungal susceptibility patterns of the most common non-albicans Candida spp. in China. Methods: We evaluated the susceptibilities to nine antifungal drugs of Candida parapsilosis species complex, Candida tropicalis, Candida glabrata species complex and Candida krusei isolates from patients with invasive candidiasis at 11 hospitals over 3 years. Isolates were identified by MALDI-TOF MS supplemented by DNA sequencing. MICs were determined by Sensititre YeastOne (TM) using current clinical breakpoints/epidemiological cut-off values to assign susceptibility (or WT), and by CLSI M44-A2 disc diffusion for fluconazole and voriconazole. Results: Of 1072 isolates, 392 (36.6%) were C. parapsilosis species complex. C. tropicalis, C. glabrata species complex and C. krusei comprised 35.4%, 24.3% and 3.7% of the isolates, respectively. Over 99.3% of the isolates were of WT phenotype to amphotericin B and 5-flucytosine. Susceptibility/WT rates to azoles among C. parapsilosis species complex were >= 97.5%. However, 11.6% and 9.5% of C. tropicalis isolates were non-susceptible to fluconazole and voriconazole, respectively (7.1% were resistant to both). Approximately 14.3% of C. glabrata sensu stricto isolates (n = 258) were fluconazole resistant, and 11.6% of C. glabrata sensu stricto isolates were cross-resistant to fluconazole and voriconazole. All C. krusei isolates were susceptible/WT to voriconazole, posaconazole and itraconazole. Overall, 97.7%-100% of isolates were susceptible to caspofungin, micafungin and anidulafungin, but 2.3% of C. glabrata were non-susceptible to anidulafungin. There was no azole/echinocandin co-resistance. Disc diffusion and Sensititre YeastOne (TM) methods showed >95% categorical agreement for fluconazole and voriconazole. Conclusions: In summary, reduced azole susceptibility was seen among C. tropicalis. Resistance to echinocandins was uncommon.
基金:
Research Special Fund for Public Welfare Industry of Health [201402001]; Postgraduate Student Innovation Fund in Peking Union Medical College [2013-1002-53]
第一作者单位:[1]Peking Union Med Coll Hosp, Dept Clin Lab, Beijing, Peoples R China
通讯作者:
推荐引用方式(GB/T 7714):
Xiao Meng,Fan Xin,Chen Sharon C. -A.,et al.Antifungal susceptibilities of Candida glabrata species complex, Candida krusei, Candida parapsilosis species complex and Candida tropicalis causing invasive candidiasis in China: 3 year national surveillance[J].JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY.2015,70(3):802-810.doi:10.1093/jac/dku460.
APA:
Xiao, Meng,Fan, Xin,Chen, Sharon C. -A.,Wang, He,Sun, Zi-Yong...&Xu, Ying-Chun.(2015).Antifungal susceptibilities of Candida glabrata species complex, Candida krusei, Candida parapsilosis species complex and Candida tropicalis causing invasive candidiasis in China: 3 year national surveillance.JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY,70,(3)
MLA:
Xiao, Meng,et al."Antifungal susceptibilities of Candida glabrata species complex, Candida krusei, Candida parapsilosis species complex and Candida tropicalis causing invasive candidiasis in China: 3 year national surveillance".JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY 70..3(2015):802-810