학술논문
Continual Decline in Azole Susceptibility Rates in Candida tropicalis Over a 9-Year Period in China
Document Type
article
Author
Yao Wang; Xin Fan; He Wang; Timothy Kudinha; Ya-Ning Mei; Fang Ni; Yu-Hong Pan; Lan-Mei Gao; Hui Xu; Hai-Shen Kong; Qing Yang; Wei-Ping Wang; Hai-Yan Xi; Yan-Ping Luo; Li-Yan Ye; Meng Xiao; China Hospital Invasive Fungal Surveillance Net (CHIF-NET) Study Group; Zi-Yong Sun; Zhong-Jv Chen; Ying-Chun Xu; Mei Kang; Yu-Ling Xiao; Kang Liao; Peng-Hao Guo; Hua Yu; Lin Yin; Da-Wen Guo; Lan-Ying Cui; Peng-Peng Liu; Hong He; Yan Jin; Hui Fan; Yun-Song Yu; Jie Lin; Ruo-Yu Li; Zhe Wan; Ling Ma; Shuai-Xian Du; Wen-En Liu; Yan-Ming Li; Tie-Li Zhou; Qing Wu; Xin-Lan Hu; Ning Li; Rong Zhang; Hong-Wei Zhou; Yi-Min Li; Dan-Hong Su; Qiang-Qiang Zhang; Li Li; Yun Xia; Li Yan; Zhi-Dong Hu; Na Yue; Yan Jiang; Zhi-Yong Liu; Yu-Ting Zheng; Wei Cao; Yun-Zhuo Chu; Fu-Shun Li; Yun Liu; Yuan-Hong Xu; Ying Huang; Wei Jia; Gang Li; Huo-Xiang Lv; Qing-Feng Hu; Xiu-Li Xu; Xiao-Yan Chen; Xiao-Ling Ma; Huai-Wei Lu; Yin-Mei Yang; Hui-Ling Chen; Jian-Sheng Huang; Hui Jing; Bin San; Yan Du; Hong-Jie Liang; Bin Yang; Yu-Lan Lin; Shan-Mei Wang; Qiong Ma; Hong-Mei Zhao; Li-Wen Liu; Qing Zhang; Fei Xia; Jin-Ying Wu; Mao-Li Yi; Xiang-Yang Chen; Wei-Ping Lu; Xiao-Yan Zeng; Jing Zhang; Jing Wang; Xiao-Guang Xiao; Jia-Yin Liang; Fan-Hua Huang; Gui-Ling Zou; Xue-Fei Du; Xiao-Ming Wang; Xu-Feng Ji; Yong Liu; Zhi-Jie Zhang; Yu-Xing Ni; Sheng-Yuan Zhao; Xiu-Lan Song; Chun-Yan Xu; Lin Meng; Xian-Feng Zhang; Jian-Hong Zhao; Hong-Lian Wei; Xue-Song Xu; Weil Li; Yu-Ping Wang; Mei Xu; Yun-Duo Wang; Jing Song; Tian-Pen Cui; Zhi-Min Hu; Ting-Yin Zhou; Hai-Qing Hu; Xiao-Min Xu; Shan-Yan Liang; Lin-Qiang Deng; Hui Chen; Xiao-Jun Sun; Hai-Bin Wang; Jian-Bang Kang; Tie-Ying Hou; Ping Ji; Na Chen; Wen-Jun Sui; Hai-Tong Gu; Xiao-Qin Ha; Yuan-Yuan Zhang; Shu-Feng Wang; Hong Lu; Yi-Hai Gu; Xuan Hou; Rong Tang; Yan-Yan Guo; Fei Huang; Long-Hua Hu; Xiao-Yan Hu; Juan Li; Lian-Hua Wei; Dan Liu; Yan-Qiu Han; Yi-Hui Yao; Jian-Sheng Wang; Jie Wang; Wei Li; Li-Ping Ning; Wei-Qing Song; Yu-Jie Wang; Liang Luan
Source
Frontiers in Microbiology, Vol 12 (2021)
Subject
Language
English
ISSN
1664-302X
Abstract
BackgroundThere have been reports of increasing azole resistance in Candida tropicalis, especially in the Asia-Pacific region. Here we report on the epidemiology and antifungal susceptibility of C. tropicalis causing invasive candidiasis in China, from a 9-year surveillance study.MethodsFrom August 2009 to July 2018, C. tropicalis isolates (n = 3702) were collected from 87 hospitals across China. Species identification was carried out by mass spectrometry or rDNA sequencing. Antifungal susceptibility was determined by Clinical and Laboratory Standards Institute disk diffusion (CHIF-NET10–14, n = 1510) or Sensititre YeastOne (CHIF-NET15–18, n = 2192) methods.ResultsOverall, 22.2% (823/3702) of the isolates were resistant to fluconazole, with 90.4% (744/823) being cross-resistant to voriconazole. In addition, 16.9 (370/2192) and 71.7% (1572/2192) of the isolates were of non-wild-type phenotype to itraconazole and posaconazole, respectively. Over the 9 years of surveillance, the fluconazole resistance rate continued to increase, rising from 5.7 (7/122) to 31.8% (236/741), while that for voriconazole was almost the same, rising from 5.7 (7/122) to 29.1% (216/741), with no significant statistical differences across the geographic regions. However, significant difference in fluconazole resistance rate was noted between isolates cultured from blood (27.2%, 489/1799) and those from non-blood (17.6%, 334/1903) specimens (P-value < 0.05), and amongst isolates collected from medical wards (28.1%, 312/1110) versus intensive care units (19.6%, 214/1092) and surgical wards (17.9%, 194/1086) (Bonferroni adjusted P-value < 0.05). Although echinocandin resistance remained low (0.8%, 18/2192) during the surveillance period, it was observed in most administrative regions, and one-third (6/18) of these isolates were simultaneously resistant to fluconazole.ConclusionThe continual decrease in the rate of azole susceptibility among C. tropicalis strains has become a nationwide challenge in China, and the emergence of multi-drug resistance could pose further threats. These phenomena call for effective efforts in future interventions.