Wang Yihui, Lin Li, Li Jiahao, Wang Xiaoyue, Zhang Junmin, Xi Liyan, Cai Wenying, Lu Sha
Department of Dermatology and Venereology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, 510120, People's Republic of China.
Infect Drug Resist. 2025 May 16;18:2557-2568. doi: 10.2147/IDR.S512301. eCollection 2025.
is an emerging multidrug-resistant yeast associated with high transmission rates in healthcare settings. This study investigates infections/colonization in a single institution to elucidate their clinical and epidemiological patterns, with the ultimate aim of informing infection control measures.
To characterize the genetic basis of antifungal resistance in , specifically through gene mutation analysis, and correlate these findings with clinical outcomes and epidemiological data. The results are intended to guide the development of targeted strategies for outbreak prevention and resistance mitigation.
A case series study of seven -infected/colonized patients (May-September 2023 and April 2024) was conducted. Epidemiological and clinical data were collected, and ITS and SNP analyses were used to examine genetic relationships and resistance profiles, focusing on fluconazole, amphotericin B, and ERG11 gene mutations.
All seven isolates were fluconazole resistant, with three also resistant to amphotericin B. ITS and SNP analysis identified two geographic clades (I and III), with clade III strains sharing mutations (V125A, F126L) and one clade I strain showing the Y132F mutation. These markers shed light on resistance mechanisms and clade-specific clustering. All patients were elderly individuals (≥64 years old) with severe underlying conditions admitted to the ICU. After was detected, their treatment became delayed or inefficient, resulting in poor clinical outcomes.
This study highlights the value of SNP and ITS analysis in uncovering genetic diversity and adaptation in . The consistent mutations in Clades I and III enhance our understanding of the genetic mechanisms influencing gene variability across clades. Additionally, the challenges in managing multidrug-resistant infections, especially in elderly patients with severe comorbidities, emphasize the urgent need for effective surveillance, infection control, and new antifungal agents.
是一种新出现的多重耐药酵母，在医疗机构中传播率很高。本研究调查了单一机构中的感染/定植情况，以阐明其临床和流行病学模式，最终目的是为感染控制措施提供依据。
具体通过基因分析来表征对唑类抗真菌药耐药的遗传基础，并将这些发现与临床结果和流行病学数据相关联。结果旨在指导制定针对性的爆发预防和耐药性缓解策略。
对7例感染/定植患者（2023年5月至9月和2024年4月）进行了病例系列研究。收集了流行病学和临床数据，并使用ITS和SNP分析来检查遗传关系和耐药谱，重点关注氟康唑、两性霉素B和ERG11基因突变。
所有7株分离株均对氟康唑耐药，其中3株也对两性霉素B耐药。ITS和SNP分析确定了两个地理分支（I和III），III分支菌株共有突变（V125A、F126L），一株I分支菌株显示Y132F突变。这些标记揭示了耐药机制和分支特异性聚类。所有患者均为入住重症监护病房的老年患者（≥64岁），有严重基础疾病。检测到后，他们的治疗延迟或无效，导致临床结果不佳。
本研究强调了SNP和ITS分析在揭示遗传多样性和适应性方面的价值。I和III分支中一致的突变增强了我们对影响各分支基因变异性的遗传机制的理解。此外，管理多重耐药感染的挑战，尤其是在患有严重合并症的老年患者中，强调了有效监测、感染控制和新型抗真菌药物的迫切需求。
