Ranđelović Marina, Ignjatović Aleksandra, Đorđević Milica, Golubović Maša, Stalević Marko, Rančić Nataša, Otašević Suzana
Department of Microbiology and Immunology, Medical Faculty, University of Niš, 18000 Niš, Serbia.
Centre of Microbiology, Public Health Institute Niš, 18000 Niš, Serbia.
J Fungi (Basel). 2025 Apr 25;11(5):338. doi: 10.3390/jof11050338.
Superficial candidiasis (SC) is widespread in humans worldwide. This study aimed to evaluate species distribution patterns and antifungal susceptibility through cluster analysis.
A total of 180 strains isolated from skin and nail samples of 1593 examined patients with suspected superficial fungal infection were identified by Matrix-assisted laser desorption in ionization-time of flight mass spectrometry (MALDI-TOF MS; Zybio EXS2600, China). Antifungal susceptibility was assessed using the commercial Integral System YEASTS Plus test (ISYPT; Liofilchem, Italy). Agglomerative hierarchical cluster analysis was used to analyze species distribution and susceptibility.
(44.4%) and (40%) were the most prevalent causative agents of SC. Cluster analysis established two defined clusters. Cluster 1 (121 isolates) showed a statistically significant difference compared to Cluster 2 (54 isolates) in species distribution ( was dominant in the first and in the second cluster) as well as in susceptibility to ECN ( ≤ 0.001), KCA ( = 0.030), CLO ( ≤ 0.001), MCZ ( ≤ 0.001), ITZ ( ≤ 0.001), and FLU ( ≤ 0.006).
The fact that one-third of isolates exhibited low sensitivity to antifungals highlights the need for a new approach in SC treatment, emphasizing the importance of mycological analyses, including in vitro testing of antifungal effectiveness.
浅表念珠菌病（SC）在全球范围内广泛存在于人类中。本研究旨在通过聚类分析评估菌种分布模式和抗真菌药敏性。
采用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS；中国Zybio EXS2600）对1593例疑似浅表真菌感染患者的皮肤和指甲样本中分离出的180株菌株进行鉴定。使用商业一体化系统酵母加样试验（ISYPT；意大利Liofilchem）评估抗真菌药敏性。采用凝聚层次聚类分析来分析菌种分布和药敏性。
白色念珠菌（44.4%）和热带念珠菌（40%）是SC最常见的病原体。聚类分析确定了两个明确的聚类。聚类1（121株分离株）与聚类2（54株分离株）相比，在菌种分布（白色念珠菌在第一个聚类中占主导，热带念珠菌在第二个聚类中占主导）以及对氟康唑（P≤0.001）、酮康唑（P = 0.030）、克霉唑（P≤0.001）、咪康唑（P≤0.001）、伊曲康唑（P≤0.001）和氟胞嘧啶（P≤0.006）的药敏性方面存在统计学显著差异。
三分之一的分离株对抗真菌药物表现出低敏感性这一事实凸显了SC治疗中需要新方法，强调了真菌学分析的重要性，包括抗真菌有效性的体外测试。
