Distribution and antifungal susceptibility pattern ofCandidaspecies from mainland China: A systematic analysis

Abstract

Antifungal resistance to Candida pathogens increases morbidity and mortality of immunosuppressive patients, an emerging crisis worldwide. Understanding the Candida prevalence and antifungal susceptibility pattern is necessary to control and treat candidiasis. We aimed to systematically analyse the susceptibility profiles of Candida species published in the last ten years (December 2011 to December 2021) from mainland China. The studies were collected from PubMed, Google Scholar, and Science Direct search engines. Out of 89 included studies, a total of 44,716 Candida isolates were collected, mainly comprising C. albicans (49.36%), C. tropicalis (21.89%), C. parapsilosis (13.92%), and C. glabrata (11.37%). The lowest susceptibility was detected for azole group; fluconazole susceptibilities against C. parapsilosis, C. albicans, C. glabrata, C. tropicalis, C. guilliermondii, C. pelliculosa , and C. auris were 93.25%, 91.6%, 79.4%, 77.95%, 76%, 50%, and 0% respectively. Amphotericin B and anidulafungin were the most susceptible drugs for all Candida species. Resistance to azole was mainly linked with mutations in ERG11, ERG3, ERG4, MRR1–2, MSH-2 , and PDR-1 genes. Mutation in FKS-1 and FKS-2 in C. auris and C. glabrata causing resistance to echinocandins was stated in two studies. Gaps in the studies’ characteristics were detected, such as 79.77%, 47.19 %, 26.97%, 7.86%, and 4.49% studies did not mention the mortality rates, age, gender, breakpoint reference guidelines, and fungal identification method, respectively. The current study demonstrates the overall antifungal susceptibility pattern of Candida species, gaps in surveillance studies and risk-reduction strategies that could be supportive in candidiasis therapy and for the researchers in their future studies.

Epidemiology and antifungal susceptibilities of clinically isolated Aspergillus species in South China

“…Similar results were reported in previously published literature from various regions of China and Europe. The high proportion of WT isolates against amphotericin B might be because of its fungicidal and limited use due to its nephrotoxicity [47]. Contrarily, triazoles are first-line therapy against aspergillosis, leading to the emergence of azole non-wild types isolates [48, 49].…”

The role of fungi in the diagnosis of colorectal cancer

“…Candida is the most prevalent and abundant fungus in the gastrointestinal tract and on other mucosal surfaces in humans and several other animals (Perez 2021 ). C. albicans is the main cause of candidiasis worldwide (Bilal et al 2022 ). Other common disease-related Candida species, such as Candida parapsilosis (Branco et al 2023 ), Candida tropicalis (Xu 2021 ), and Candida auris (Bing et al 2022 ; Du et al 2022 ), are also concerning.…”

Interleukin inhibitors and the associated risk of candidiasis

“…These opportunistic pathogens are typically present on the skin and mucous membranes of healthy individual’s without causing infections ( 2 ). However, the risk factors of candidiasis are heightened in patients with compromised immune systems, often due to conditions such as diabetes, renal failure or liver failure ( 1 , 3 ).…”