Sang Qian-Yu, Liao Yun-Hui, Huang Kai-Xuan, Xie Yin-Rong, Yao Yi-Hui, Chen Ping, Liang Xian-Ming
Department of Clinical Laboratory, Xiamen Hospital of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Xiamen 361000, PR China.
Centre of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361004, PR China.
J Med Microbiol. 2025 May;74(5). doi: 10.1099/jmm.0.002011.
In recent years, with the increase of drug resistance of , the incidence rate and mortality of candidemia have gradually increased, which has brought a huge economic and health burden to people. The epidemiological characteristics and antifungal drug sensitivity patterns in different regions have varied. To analyse the distribution and antifungal susceptibility of strains isolated from bloodstreams and provide a basis for the use of antifungal drugs for treatment. A total of 115 strains of were collected from the bloodstream, and 28 strains of colonized were collected from the upper respiratory tract. species were identified using matrix-assisted laser desorption/ionization time-of-flight technology. Antifungal susceptibility was assessed using broth microdilution combined with redox methods. There were eight types of strains isolated from the bloodstream; was the most common species (36.5%), followed by (24.3%), (17.4%) and (14.8%). There was no significant difference in the resistance of to azole drugs between the bloodstream infection group and the upper respiratory tract colonization group, but there was a significant difference in the MIC values of micafungin and fluconazole, with values of 0.017 and 0.003, respectively. Amphotericin B and echinocandins are the most susceptible drugs for all species, but the MICs of echinocandins against are significantly higher than those of other species. (except for ) is highly resistant to azoles, with showing resistance rates of 89.3% and 82.1% to itraconazole and posaconazole, respectively; the resistance rates of are 100% and 94.1%, respectively. remains the predominant pathogen responsible for candidemia. Although the resistance of to antifungals is relatively stable, there are significant differences in the MICs of antifungal drugs against , indicating the importance of strain identification in the treatment of candidemia. For empirical treatment, the use of echinocandin drugs is recommended.
近年来，随着念珠菌耐药性的增加，念珠菌血症的发病率和死亡率逐渐上升，给人们带来了巨大的经济和健康负担。不同地区的流行病学特征和抗真菌药物敏感性模式各不相同。为分析从血流中分离出的念珠菌菌株的分布及抗真菌药敏情况，为抗真菌药物治疗提供依据。共从血流中收集到115株念珠菌，从上呼吸道收集到28株定植念珠菌。采用基质辅助激光解吸/电离飞行时间技术鉴定念珠菌种类。采用肉汤微量稀释法结合氧化还原法评估抗真菌药敏情况。从血流中分离出的念珠菌菌株有8种类型；白色念珠菌是最常见的菌种（36.5%），其次是光滑念珠菌（24.3%）、热带念珠菌（17.4%）和近平滑念珠菌（14.8%）。血流感染组与上呼吸道定植组念珠菌对唑类药物的耐药性无显著差异，但米卡芬净和氟康唑的MIC值有显著差异，分别为0.017和0.003。两性霉素B和棘白菌素是所有念珠菌属最敏感的药物，但棘白菌素对光滑念珠菌的MIC值显著高于其他念珠菌属。克柔念珠菌（除了某些菌株外）对唑类高度耐药，光滑念珠菌对伊曲康唑和泊沙康唑的耐药率分别为89.3%和82.1%；克柔念珠菌的耐药率分别为100%和94.1%。白色念珠菌仍然是念珠菌血症的主要病原体。虽然念珠菌对抗真菌药物的耐药性相对稳定，但抗真菌药物对念珠菌的MIC值存在显著差异，表明菌株鉴定在念珠菌血症治疗中的重要性。对于经验性治疗，建议使用棘白菌素类药物。
