susceptibility profiles of species complex subtypes from deep infections to nine antifungal drugs.

The complex can be divided into , , and subtypes. It is uncommon for drug sensitivity tests to type them. In routine susceptibility reports, drug susceptibility of complex subtypes is lacking. The aim of this study is to investigate the antifungal susceptibility and clinical distribution characteristics of the complex subtypes causing deep infection in patients. Non-repetitive strains of complex isolated from deep infection from 2017 to 2019 were collected. Species-level identification was performed using a matrix-assisted laser desorption/ionization time-of-flight mass spectrometer and confirmed using gene sequencing, when necessary. Antifungal susceptibility testing was performed using the Sensititre YeastOne system method. A total of 244 cases were included in the study, including 176 males (72.13 %, 60.69±13.43 years) and 68 females (27.87 %, 60.21±10.59 years). The primary diseases were cancer (43.44 %), cardiovascular disease (25.00 %), digestive system diseases, (18.44 %), infection (6.97 %), and nephropathy (6.15 %). Strains were isolated from the bloodstream (63.11 %), central venous catheters (15.16 %), pus (6.56 %), ascites (5.74 %), sterile body fluid (5.33 %), and bronchoalveolar lavage fluid (BALF, 4.09 %). Of the 244 complex strains, 179 (73.26 %) were identified as , 62 (25.41 %) were , and three (1.23 %) were . Only one strain was resistant to anidulafungin, micafungin, caspofungin, and voriconazole, and it was non-wild-type (NWT) to amphotericin B. Furthermore, six strains were resistant to fluconazole, and one was dose-dependent susceptible. Five strains were NWT to posaconazole. Only one strain was NWT for anidulafungin, micafungin, caspofungin, fluconazole, voriconazole, amphotericin B, and posaconazole, while the rest of the strains were wild-type. was the main clinical isolate from the complex in our hospital. Most strains were isolated from the bloodstream. The susceptibility rate to commonly used antifungal drugs was more than 96 %. Furthermore, most of the infected patients were elderly male cancer patients.