Xie Wenting, Liang Guanzhao, Kong Xue, Tsui Clement K M, She Xiaodong, Liu Weida, Li Xiaofang
Department of Medical Mycology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, People's Republic of China.
Jiangsu Key Laboratory of Molecular Biology for Skin Diseases and STIs, Nanjing, People's Republic of China.
Emerg Microbes Infect. 2025 Dec;14(1):2498571. doi: 10.1080/22221751.2025.2498571. Epub 2025 May 12.
The emergence and spread of antifungal-resistant pose an increasing public health concern worldwide. Multidrug-resistant infections have been reported in China in the past few years. To understand the genetic relationship and the origin of these Chinese isolates, as well as their relationship to the global collections, we sequenced the whole genomes of 31 isolates using the Illumina platforms. Genomic epidemiology was performed on a dataset of 181 isolates from China and 8 other countries, representing the largest genome-wide analysis. Single nucleotide polymorphism analysis revealed that can be divided into four distinct phylogenetic groups (I, II, III, IV), with regional clonal transmission clusters identified in eastern China; was introduced into China more than once given the genetic variability. The isolates from South Asia may be the source of Chinese isolates based on epidemiological information. There were differences in the prevalence and resistance profiles among four phylogenetic groups, with Group III being predominant and exhibiting a higher terbinafine resistance rate of 88.24% and azole resistance. Also, we characterized the role of gene mutation, copy number variation, and gene expression in antifungal drug resistance. Terbinafine resistance could be mainly associated with Phe397Leu substitution in , and azole resistance might be related to increased copy number of , as well as elevated and expression. Given the clinical challenges posed by , this emerging dermatophyte should be recognized as a global threat, necessitating urgent collaborative surveillance and management strategies.
耐真菌菌株的出现和传播在全球范围内引起了越来越多的公共卫生关注。过去几年中国已报告了多重耐药感染情况。为了解这些中国分离株的遗传关系、起源以及它们与全球菌株库的关系，我们使用Illumina平台对31株分离株的全基因组进行了测序。对来自中国和其他8个国家的181株分离株数据集进行了基因组流行病学分析，这是最大规模的全基因组分析。单核苷酸多态性分析表明，可分为四个不同的系统发育组（I、II、III、IV），在中国东部发现了区域克隆传播簇；鉴于遗传变异性，已不止一次传入中国。根据流行病学信息，南亚的分离株可能是中国分离株的来源。四个系统发育组在流行率和耐药谱方面存在差异，其中III组占主导地位，特比萘芬耐药率较高，为88.24%，且对唑类耐药。此外，我们还确定了基因突变、拷贝数变异和基因表达在抗真菌药物耐药性中的作用。特比萘芬耐药可能主要与中Phe397Leu替代有关，唑类耐药可能与拷贝数增加以及和表达升高有关。鉴于带来的临床挑战，这种新兴皮肤癣菌应被视为全球威胁，迫切需要采取协作监测和管理策略。
