<p>Species Distribution and Antifungal Susceptibility of Invasive Candidiasis: A 2016-2017 Multicenter Surveillance Study in Beijing, China</p>

Abstract

Objective: Invasive candidiasis (IC), a life-threatening fungal infection prevalent among hospitalized patients, has highly variable regional epidemiology. We conducted a multicenter surveillance study to investigate recent trends in species distribution and antifungal susceptibility patterns among IC-associated Candida spp. in Beijing, China, from 2016 to 2017. Materials and Methods: A total of 1496 non-duplicate Candida isolates, recovered from blood and other sterile body fluids of IC patients, were identified using matrix-assisted laser desorption/ionization time of flight mass spectrometry combined with ribosomal DNA internal transcribed spacer (ITS) region sequencing. Broth microdilution-based susceptibility testing using six antifungal agents was also conducted. Results: Candida albicans was the most frequently isolated species (49.9%), followed by Candida tropicalis (15.5%), Candida glabrata (14.7%) and Candida parapsilosis (14.2%). No significant differences in species distribution were observed when compared with a 2012-2013 dataset. Overall, the rates of susceptibility to fluconazole and voriconazole were high among C. albicans (98% and 97.2%, respectively) and C. parapsilosis species complex (91.1% and 92%, respectively) isolates but low among C. tropicalis (81.5% and 81.1%, respectively) isolates. In addition, the rate of azole resistance among C. tropicalis isolates increased significantly (1.8-fold, P<0.05) compared with that observed in 2012-2013, while micafungin resistance rates were <5% for all tested Candida species. Conclusion: Our results suggest that species distribution has remained stable among ICassociated Candida isolates in Beijing. Resistance to micafungin was rare, but increased azole resistance among C. tropicalis isolates was noted. Our study provides information on local epidemiology that will be important for the selection of empirical antifungal agents and contributes to global assessments of antifungal resistance.

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

“…Among the azole class, the highest MS (95%CI) was observed for voriconazole (83.96%, (73–89.4)) while fluconazole (77.95%, (65.4–83.3%)) was among the less susceptible drugs. For 5-flucytosine, variations in susceptibilities were reported between IC/BSI and VVC/OC groups, in which the MS (95% CI) were 99.8% [ 68–71 ] and 92.57% (89.7–100), respectively. The AST pattern of C. tropicalis against all antifungal drugs is depicted in Figure 4 .…”

Epidemiological Profile and Detection of Resistance Genes in Bloodstream Infection in Cancer Patients: High Occurrence of Metallo-β-lactamases in Enterobacteriales

“…Our result showed resistance to voriconazole in all Candidas spp. The rate of azole resistance among C. tropicalis has been signi cant compared to rates of resistance to micafungin 71 . The antifungal caspofugin showed dose-dependent susceptibility in Candida tropicalis (1/4).…”

Correlation Between Drug Resistance and Virulence of Candida Isolates from Patients with Candidiasis

“…3 Today, the global prevalence of candidemia is 6.9/1000 persons 4 and approximately 250,000 new cases of IC are reported per year, of which more than 50,000 result in death, although others have reported a mortality rate of up to 60%. [5][6][7] There are more than 15 species of Candida spp. identified as human pathogens.…”