Fungal Spectrum and Susceptibility Against Nine Antifungal Agents in 525 Deep Fungal Infected Cases.

BACKGROUND

Deep fungal infection has become an important cause of infection and death in hospitalized patients, and this has worsened with increasing antifungal drug resistance.

OBJECTIVE

A 3-year retrospective study was conducted to investigate the clinical characteristics, pathogen spectrum, and drug resistance of deep fungal infection in a regional hospital of Guangzhou, China.

METHODS

Non-duplicate fungi isolates recovered from blood and other sterile body fluids of in-patients of the clinical department were identified using biochemical tests of pure culture with the API20C AUX and CHROMagar medium. Antifungal susceptibilities were determined by Sensititre YeastOne panel trays.

RESULTS

In this study, 525 patients (283 female, 242 male) with deep fungal infection were included, half of them were elderly patients (≥60 years) (54.67%, n=286). A total of 605 non-repetitive fungi were finally isolated from sterile samples, of which urine specimens accounted for 66.12% (n=400). Surgery, ICU, and internal medicine were the top three departments that fungi were frequently detected. The mainly isolated fungal species were (43.97%, n=266), (20.00%, n=121), and (17.02%, n=103), which contributed to over 80% of fungal infection. The susceptibility of the spp. to echinocandins, 5-fluorocytosine, and amphotericin B remained above 95%, while and to itraconazole were about 95%, and the dose-dependent susceptibility of to fluconazole was more than 90%. The echinocandins had no antifungal activity against in vitro (MIC>8 μg/mL), but azole drugs were good, especially voriconazole and itraconazole (MIC = 0.25 μg/mL).

CONCLUSION

The main causative agents of fungal infection were still the genus of . Echinocandins were the first choice for clinical therapy of infection, followed with 5-fluorocytosine and amphotericin B. Azole antifungal agents should be used with caution in and infections.