Prevalence and Antifungal Susceptibility of Candida parapsilosis Species Complex in Eastern China: A 15-Year Retrospective Study by ECIFIG.
Prevalence and Antifungal Susceptibility of Candida parapsilosis Species Complex in Eastern China: A 15-Year Retrospective Study by ECIFIG.
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华东地区近平滑念珠菌种属复合体的患病率和抗真菌药敏：ECIFIG的15年回顾性研究。
DOI：
10.3389/fmicb.2021.644000
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发表时间：
2021
影响因子：
5.2
通讯作者：
Wu W
中科院分区：
文献类型：
--
作者：
Guo J;Zhang M;Qiao D;Shen H;Wang L;Wang D;Li L;Liu Y;Lu H;Wang C;Ding H;Zhou S;Zhou W;Wei Y;Zhang H;Xi W;Zheng Y;Wang Y;Tang R;Zeng L;Xu H;Wu W
近平滑念珠菌复合体是引起念珠菌血症，特别是侵袭性念珠菌病的最常见的非白念珠菌属。本研究的目的是评估临床定植和侵袭性念珠菌的抗真菌能力。近平滑综合征分离株对10种药物的敏感性：阿替霉素（AMB）、阿尼芬净（AFG）、卡泊芬净（CAS）、米卡芬净（MFG）、氟康唑（FLZ）、伏立康唑（VRZ）、伊曲康唑（ITZ）、泊沙康唑（POZ）、5-氟胞嘧啶（FCY）和异康唑（伊萨）。共计884株C.在2005年1月至2020年12月期间收集了近平滑病种复合体分离株。C.近平滑假丝酵母、偏平滑假丝酵母和正平滑假丝酵母分别占隐种的86.3%、8.1%和5.5%。血流C的耐药/非野生型率。对药物的近平滑反应为3.5%，C.对AFG和CAS的代谢率为7.7%;对FLZ和VRZ的阳性率为15%，对CAS、MFG和POZ的阳性率为5%。非血流C的几何平均（GM）最小抑菌浓度（MIC）。CAS（0.555 mg/L）、MFG（0.853 mg/L）、FLZ（0.816 mg/L）、VRZ（0.017 mg/L）、ITZ（0.076 mg/L）和POZ（0.042 mg/L）的近平滑度显著高于血流C。GM对近平滑病的MIC分别为0.464、0.745、0.704、0.015、0.061和0.033 mg/L（P < 0.05）。血液中的MIC分布C. 2019 - 2020年VRZ、POZ和ITZ采集的近平滑体菌株为0.018、0.040和0.073 mg/L，显著高于2005 - 2018年的0.013、0.028和0.052 mg/L（P < 0.05）。此外，C.近平滑带FLZ的分布和C.与ITZ和POZ的骨科可能高于临床和实验室标准研究所的研究。此外，共有143个C。近平滑复合体菌株对伊萨高度敏感。总的来说，非血流C。近平滑复合体菌株应管理和改进。提示临床应重视唑类药物的应用。近平滑复合体分离株。此外，建立唑类药物在华东地区的流行病学临界值（ECV）可能为临床治疗提供更好的指导。虽然伊萨与其他唑类药物作用于相同的靶点，但它可作为FLZ或VRZ耐药的C。近平滑复合体菌株。
Candida parapsilosis complex is one of the most common non-albicans Candida species that cause candidemia, especially invasive candidiasis. The purpose of this study was to evaluate the antifungal susceptibilities of both colonized and invasive clinical C. parapsilosis complex isolates to 10 drugs: amphotericin (AMB), anidulafungin (AFG), caspofungin (CAS), micafungin (MFG), fluconazole (FLZ), voriconazole (VRZ), itraconazole (ITZ), posaconazole (POZ), 5-flucytosine (FCY), and isaconazole (ISA). In total, 884 C. parapsilosis species complex isolates were gathered between January 2005 and December 2020. C. parapsilosis, Candida metapsilosis, and Candida orthopsilosis accounted for 86.3, 8.1, and 5.5% of the cryptic species, respectively. The resistance/non-wild-type rate of bloodstream C. parapsilosis to the drugs was 3.5%, of C. metapsilosis to AFG and CAS was 7.7%, and of C. orthopsilosis to FLZ and VRZ was 15% and to CAS, MFG, and POZ was 5%. The geometric mean (GM) minimum inhibitory concentrations (MICs) of non-bloodstream C. parapsilosis for CAS (0.555 mg/L), MFG (0.853 mg/L), FLZ (0.816 mg/L), VRZ (0.017 mg/L), ITZ (0.076 mg/L), and POZ (0.042 mg/L) were significantly higher than those of bloodstream C. parapsilosis, for which the GM MICs were 0.464, 0.745, 0.704, 0.015, 0.061, and 0.033 mg/L, respectively (P < 0.05). The MIC distribution of the bloodstream C. parapsilosis strains collected from 2019 to 2020 for VRZ, POZ, and ITZ were 0.018, 0.040, and 0.073 mg/L, significantly higher than those from 2005 to 2018, which were 0.013, 0.028, and 0.052 mg/L (P < 0.05). Additionally, MIC distributions of C. parapsilosis with FLZ and the distributions of C. orthopsilosis with ITZ and POZ might be higher than those in Clinical and Laboratory Standards Institute studies. Furthermore, a total of 143 C. parapsilosis complex isolates showed great susceptibility to ISA. Overall, antifungal treatment of the non-bloodstream C. parapsilosis complex isolates should be managed and improved. The clinicians are suggested to pay more attention on azoles usage for the C. parapsilosis complex isolates. In addition, establishing the epidemiological cutoff values (ECVs) for azoles used in Eastern China may offer better guidance for clinical treatments. Although ISA acts on the same target as other azoles, it may be used as an alternative therapy for cases caused by FLZ- or VRZ-resistant C. parapsilosis complex strains.
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影响因子：
9.4
作者：
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