Zhou Xinyu, Zheng Yanqing, Zheng Dongyan, Jiang Zhiwen, Pan Kaisu, Liu Guoqun, Karki Saroj, He Xiaojuan, Cao Cunwei
Department of Dermatology and Venereology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, China.
Guangxi Scientific and Technological Innovation Cooperation Base of Mycosis Prevention and Control, Nanning, Guangxi 530021, China.
Med Mycol. 2025 Jun 5;63(6). doi: 10.1093/mmy/myaf047.
Long-term trends in the antifungal susceptibility of Talaromyces marneffei isolates have not been well characterized. We conducted a 40-year surveillance study analyzing the antifungal susceptibility of 131 T. marneffei isolates collected from the clinical laboratory of the First Affiliated Hospital of Guangxi Medical University between 1984 and 2024. In vitro susceptibilities to conventional antifungal agents, including itraconazole, voriconazole, fluconazole, and amphotericin B, were analyzed using the Clinical and Laboratory Standards Institute broth microdilution method. We also explored the potential influence of host Human Immunodeficiency Virus (HIV) status and fungal mating type (MAT) on susceptibility patterns. The minimum inhibitory concentrations (MICs) for itraconazole, voriconazole, fluconazole, and amphotericin B ranged from 0.015 to 0.06 μg/ml, 0.008 to 0.03 μg/ml, 1 to 8 μg/ml, and 0.25 to 1 μg/ml, respectively. Fluconazole showed a significant decline in susceptibility over time (P < .01), whereas the susceptibilities to the other antifungals remained stable (P > .05). The correlations observed between the MICs of different triazoles (P < .01) suggest potential cross-resistance among triazoles. MAT and HIV infection status did not significantly affect antifungal susceptibility patterns (P > .05). These findings underscore the importance of ongoing antifungal susceptibility surveillance in T. marneffei, considering the changes in fluconazole susceptibility and potential triazole cross-resistance, while other antifungals remain stable.
马尔尼菲篮状菌分离株的抗真菌药敏长期趋势尚未得到充分描述。我们进行了一项为期40年的监测研究，分析了1984年至2024年期间从广西医科大学第一附属医院临床实验室收集的131株马尔尼菲篮状菌分离株的抗真菌药敏情况。使用临床和实验室标准协会肉汤微量稀释法分析了对传统抗真菌药物（包括伊曲康唑、伏立康唑、氟康唑和两性霉素B）的体外药敏情况。我们还探讨了宿主人类免疫缺陷病毒（HIV）状态和真菌交配型（MAT）对药敏模式的潜在影响。伊曲康唑、伏立康唑、氟康唑和两性霉素B的最低抑菌浓度（MIC）分别为0.015至0.06μg/ml、0.008至0.03μg/ml、1至8μg/ml和0.25至1μg/ml。氟康唑的药敏随时间显著下降（P < 0.01），而对其他抗真菌药物的药敏保持稳定（P > 0.05）。不同三唑类药物MIC之间的相关性（P < 0.01）表明三唑类药物之间可能存在交叉耐药性。MAT和HIV感染状态对抗真菌药敏模式没有显著影响（P > 0.05）。考虑到氟康唑药敏的变化和潜在的三唑类交叉耐药性，而其他抗真菌药物保持稳定，这些发现强调了对马尔尼菲篮状菌持续进行抗真菌药敏监测的重要性。
