Rodríguez-Cerdeira Carmen, Pinto-Almazán Rodolfo, Saunte Ditte M L, Hay R, Szepietowski Jacek C, Moreno-Coutiño Gabriela, Skerlev Mihael, Prohic Asja, Martínez-Herrera Erick
Dermatology Department, Hospital Vithas Vigo, Vigo, Spain.
Fundación Vithas, Grupo Hospitalario Vithas, Madrid, Spain.
J Eur Acad Dermatol Venereol. 2025 Feb;39(2):377-388. doi: 10.1111/jdv.20273. Epub 2024 Aug 13.
Nakaseomyces glabratus (N. glabratus) formerly known as Candida glabrata (C. glabrata), is an endogenous opportunistic pathogen, which is generally located in the gastrointestinal tract but can spread in immunocompromised patients. N. glabratus is the second most common pathogen that causes candidemia in several countries. N. glabratus virulence factors may increase antifungal resistance and reduce the number of available treatment options. High resistance to azoles and increasing resistance to echinocandins have been previously reported in N. glabratus.
To establish the distribution of N. glabratus isolates in Europe and its drug susceptibility/resistance in each country over the last 7 years.
The search was performed across three databases: PubMed, Scopus and Scielo, using the MeSH terms: "Candida glabrata", "Nakaseomyces glabratus", "Europe", "resistance" and "Epidemiology" exclusively in English. All available information from January 2002 to December 2022 was included, excluding reviews, meta-analyses and book chapters.
Fifty-seven articles with information on antifungal susceptibility in Europe were retrieved and analysed with a total of 15,400 reported C. glabrata isolates. Remarkably, nations that presented the maximum number of cases during the study period included the United Kingdom (n = 7241, 47.02%), France (n = 3190, 20.71%), Spain (n = 900, 5.84%), Hungary (n = 745, 4.84%) and Italy (n = 486, 3.16%). C. glabrata isolates presented resistance to azoles [voriconazole (n = 2225, 14.45%), fluconazole (n = 1612, 10.47%), itraconazole (n = 337, 2.19%) and clotrimazole (n = 89, 0.58%)], increased resistance to echinocandins, especially to anidulafungin (n = 138, 0.89%), and high sensitivity to amphotericin B.
The number of candidemia cases associated with triazole-resistant N. glabratus isolates have been increasing in Europe. Therefore, echinocandins and amphotericin B can be considered optional empirical treatments; however, antifungal susceptibility testing is required to determine the best therapeutic options.
光滑念珠菌（Nakaseomyces glabratus，曾称光滑假丝酵母菌（Candida glabrata））是一种内源性机会致病菌，通常存在于胃肠道，但在免疫功能低下的患者中可扩散。光滑念珠菌是几个国家中引起念珠菌血症的第二常见病原体。光滑念珠菌的毒力因子可能会增加抗真菌耐药性，并减少可用的治疗选择数量。此前已有报道称光滑念珠菌对唑类药物具有高度耐药性，且对棘白菌素类药物的耐药性也在增加。
确定过去7年欧洲光滑念珠菌分离株的分布情况及其在每个国家的药物敏感性/耐药性。
在三个数据库（PubMed、Scopus和Scielo）中进行检索，仅使用英文的医学主题词：“光滑假丝酵母菌”、“光滑念珠菌”、“欧洲”、“耐药性”和“流行病学”。纳入了2002年1月至2022年12月的所有可用信息，排除综述、荟萃分析和书籍章节。
检索并分析了57篇有关欧洲抗真菌药敏性的文章，共报告了15400株光滑假丝酵母菌分离株。值得注意的是，在研究期间病例数最多的国家包括英国（n = 7241，47.02%）、法国（n = 3190，20.71%）、西班牙（n = 900，5.84%）、匈牙利（n = 745，4.84%）和意大利（n = 486，3.16%）。光滑假丝酵母菌分离株对唑类药物耐药[伏立康唑（n = 2225，14.45%）、氟康唑（n = 1612，10.47%）、伊曲康唑（n = 337，2.19%）和克霉唑（n = 89，0.58%）]，对棘白菌素类药物的耐药性增加，尤其是对阿尼芬净（n = 138，0.89%），对两性霉素B高度敏感。
在欧洲，与对三唑耐药的光滑念珠菌分离株相关的念珠菌血症病例数一直在增加。因此，棘白菌素类药物和两性霉素B可被视为可选的经验性治疗药物；然而，需要进行抗真菌药敏试验以确定最佳治疗方案。
