Department of Laboratory Medicine, Peking Union Medical College Hospital, Beijing, China.
Graduate School, Peking Union Medical College, Beijing, China.
J Infect Dis. 2020 Mar 16;221(Suppl 2):S139-S147. doi: 10.1093/infdis/jiz573.
Candidemia is the most common, serious fungal infection and Candida antifungal resistance is a challenge. We report recent surveillance of candidemia in China.
The study encompassed 77 Chinese hospitals over 3 years. Identification of Candida species was by mass spectrometry and DNA sequencing. Antifungal susceptibility was determined using the Clinical and Laboratory Standards Institute broth microdilution method.
In total, 4010 isolates were collected from candidemia patients. Although C. albicans was the most common species, non-albicans Candida species accounted for over two-thirds of isolates, predominated C. parapsilosis complex (27.1%), C. tropicalis (18.7%), and C. glabrata complex (12.0%). Most C. albicans and C. parapsilosis complex isolates were susceptible to all antifungal agents (resistance rate <5%). However, there was a decrease in voriconazole susceptibility to C. glabrata sensu stricto over the 3 years and fluconazole resistance rate in C. tropicalis tripled. Amongst less common Candida species, over one-third of C. pelliculosa isolates were coresistant to fluconazole and 5-flucytocine, and >56% of C. haemulonii isolates were multidrug resistance.
Non-albicans Candida species are the predominant cause of candidemia in China. Azole resistance is notable amongst C. tropicalis and C. glabrata. Coresistance and multidrug resistance has emerged in less common Candida species.
念珠菌血症是最常见、最严重的真菌感染，而念珠菌的抗真菌耐药性是一个挑战。我们报告了中国近期的念珠菌血症监测情况。
该研究涵盖了 3 年内的 77 家中国医院。通过质谱和 DNA 测序鉴定念珠菌种。使用临床和实验室标准协会肉汤微量稀释法测定抗真菌药敏性。
共从念珠菌血症患者中收集了 4010 株分离株。虽然 C. albicans 是最常见的菌种，但非白念珠菌念珠菌占分离株的三分之二以上，以近平滑念珠菌复合体（27.1%）、热带念珠菌（18.7%）和光滑念珠菌复合体（12.0%）为主。大多数 C. albicans 和近平滑念珠菌复合体分离株对所有抗真菌药物均敏感（耐药率<5%）。然而，3 年来，C. glabrata stricto 对伏立康唑的敏感性下降，C. tropicalis 的氟康唑耐药率增加了两倍。在较少见的念珠菌种中，超过三分之一的 C. pelliculosa 分离株对氟康唑和 5-氟胞嘧啶具有核心耐药性，超过 56%的 C. haemulonii 分离株具有多药耐药性。
非白念珠菌念珠菌是中国念珠菌血症的主要原因。唑类耐药在热带念珠菌和光滑念珠菌中很明显。在较少见的念珠菌种中出现了联合耐药和多药耐药。
