Prevalence and Antifungal Susceptibility of Candida parapsilosis Species Complex in Eastern China: A 15-Year Retrospective Study by ECIFIG
Candida parapsilosis complex is one of the most common non-albicans Candida species that cause candidemia, especially invasive candidiasis. The purpose of this study was to evaluate the antifungal susceptibilities of both colonized and invasive clinical C. parapsilosis complex isolates to 10 drugs:...
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Frontiers Media S.A.
2021-03-01
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Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2021.644000/full |
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doaj-514a52aef58e469a99c245f83a5ae236 |
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record_format |
Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Jian Guo Min Zhang Dan Qiao Hui Shen Lili Wang Dongjiang Wang Li Li Yun Liu Huaiwei Lu Chun Wang Hui Ding Shuping Zhou Wanqing Zhou Yingjue Wei Haomin Zhang Wei Xi Yi Zheng Yueling Wang Rong Tang Lingbing Zeng Heping Xu Wenjuan Wu |
spellingShingle |
Jian Guo Min Zhang Dan Qiao Hui Shen Lili Wang Dongjiang Wang Li Li Yun Liu Huaiwei Lu Chun Wang Hui Ding Shuping Zhou Wanqing Zhou Yingjue Wei Haomin Zhang Wei Xi Yi Zheng Yueling Wang Rong Tang Lingbing Zeng Heping Xu Wenjuan Wu Prevalence and Antifungal Susceptibility of Candida parapsilosis Species Complex in Eastern China: A 15-Year Retrospective Study by ECIFIG Frontiers in Microbiology antifungal susceptibility Candida parapsilosis Candida metapsilosis Candida orthopsilosis China |
author_facet |
Jian Guo Min Zhang Dan Qiao Hui Shen Lili Wang Dongjiang Wang Li Li Yun Liu Huaiwei Lu Chun Wang Hui Ding Shuping Zhou Wanqing Zhou Yingjue Wei Haomin Zhang Wei Xi Yi Zheng Yueling Wang Rong Tang Lingbing Zeng Heping Xu Wenjuan Wu |
author_sort |
Jian Guo |
title |
Prevalence and Antifungal Susceptibility of Candida parapsilosis Species Complex in Eastern China: A 15-Year Retrospective Study by ECIFIG |
title_short |
Prevalence and Antifungal Susceptibility of Candida parapsilosis Species Complex in Eastern China: A 15-Year Retrospective Study by ECIFIG |
title_full |
Prevalence and Antifungal Susceptibility of Candida parapsilosis Species Complex in Eastern China: A 15-Year Retrospective Study by ECIFIG |
title_fullStr |
Prevalence and Antifungal Susceptibility of Candida parapsilosis Species Complex in Eastern China: A 15-Year Retrospective Study by ECIFIG |
title_full_unstemmed |
Prevalence and Antifungal Susceptibility of Candida parapsilosis Species Complex in Eastern China: A 15-Year Retrospective Study by ECIFIG |
title_sort |
prevalence and antifungal susceptibility of candida parapsilosis species complex in eastern china: a 15-year retrospective study by ecifig |
publisher |
Frontiers Media S.A. |
series |
Frontiers in Microbiology |
issn |
1664-302X |
publishDate |
2021-03-01 |
description |
Candida parapsilosis complex is one of the most common non-albicans Candida species that cause candidemia, especially invasive candidiasis. The purpose of this study was to evaluate the antifungal susceptibilities of both colonized and invasive clinical C. parapsilosis complex isolates to 10 drugs: amphotericin (AMB), anidulafungin (AFG), caspofungin (CAS), micafungin (MFG), fluconazole (FLZ), voriconazole (VRZ), itraconazole (ITZ), posaconazole (POZ), 5-flucytosine (FCY), and isaconazole (ISA). In total, 884 C. parapsilosis species complex isolates were gathered between January 2005 and December 2020. C. parapsilosis, Candida metapsilosis, and Candida orthopsilosis accounted for 86.3, 8.1, and 5.5% of the cryptic species, respectively. The resistance/non-wild-type rate of bloodstream C. parapsilosis to the drugs was 3.5%, of C. metapsilosis to AFG and CAS was 7.7%, and of C. orthopsilosis to FLZ and VRZ was 15% and to CAS, MFG, and POZ was 5%. The geometric mean (GM) minimum inhibitory concentrations (MICs) of non-bloodstream C. parapsilosis for CAS (0.555 mg/L), MFG (0.853 mg/L), FLZ (0.816 mg/L), VRZ (0.017 mg/L), ITZ (0.076 mg/L), and POZ (0.042 mg/L) were significantly higher than those of bloodstream C. parapsilosis, for which the GM MICs were 0.464, 0.745, 0.704, 0.015, 0.061, and 0.033 mg/L, respectively (P < 0.05). The MIC distribution of the bloodstream C. parapsilosis strains collected from 2019 to 2020 for VRZ, POZ, and ITZ were 0.018, 0.040, and 0.073 mg/L, significantly higher than those from 2005 to 2018, which were 0.013, 0.028, and 0.052 mg/L (P < 0.05). Additionally, MIC distributions of C. parapsilosis with FLZ and the distributions of C. orthopsilosis with ITZ and POZ might be higher than those in Clinical and Laboratory Standards Institute studies. Furthermore, a total of 143 C. parapsilosis complex isolates showed great susceptibility to ISA. Overall, antifungal treatment of the non-bloodstream C. parapsilosis complex isolates should be managed and improved. The clinicians are suggested to pay more attention on azoles usage for the C. parapsilosis complex isolates. In addition, establishing the epidemiological cutoff values (ECVs) for azoles used in Eastern China may offer better guidance for clinical treatments. Although ISA acts on the same target as other azoles, it may be used as an alternative therapy for cases caused by FLZ- or VRZ-resistant C. parapsilosis complex strains. |
topic |
antifungal susceptibility Candida parapsilosis Candida metapsilosis Candida orthopsilosis China |
url |
https://www.frontiersin.org/articles/10.3389/fmicb.2021.644000/full |
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doaj-514a52aef58e469a99c245f83a5ae2362021-03-04T04:46:33ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2021-03-011210.3389/fmicb.2021.644000644000Prevalence and Antifungal Susceptibility of Candida parapsilosis Species Complex in Eastern China: A 15-Year Retrospective Study by ECIFIGJian Guo0Min Zhang1Dan Qiao2Hui Shen3Lili Wang4Dongjiang Wang5Li Li6Yun Liu7Huaiwei Lu8Chun Wang9Hui Ding10Shuping Zhou11Wanqing Zhou12Yingjue Wei13Haomin Zhang14Wei Xi15Yi Zheng16Yueling Wang17Rong Tang18Lingbing Zeng19Heping Xu20Wenjuan Wu21Department of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Laboratory Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Laboratory Medicine, Changhai Hospital, Naval Medical University (Second Military Medical University), Shanghai, ChinaDepartment of Laboratory Medicine, The First Affiliated Hospital of USTC, Hefei, ChinaDepartment of Laboratory Medicine, Children’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Laboratory Medicine, Lishui Municipal Central Hospital, Lishui, ChinaDepartment of Laboratory Medicine, Jiangxi Provincial Children’s Hospital, Nanchang, ChinaDepartment of Laboratory Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing University, Nanjing, ChinaDepartment of Laboratory Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Laboratory Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, ChinaDepartment of Laboratory Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China0Department of Clinical Laboratory, The Second Affiliated Hospital of Soochow University, Suzhou, China1Department of Clinical Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China2Department of Laboratory Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China3Department of Laboratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China4Department of Laboratory Medicine, The First Affiliated Hospital of Xiamen University, Xiamen, ChinaDepartment of Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, ChinaCandida parapsilosis complex is one of the most common non-albicans Candida species that cause candidemia, especially invasive candidiasis. The purpose of this study was to evaluate the antifungal susceptibilities of both colonized and invasive clinical C. parapsilosis complex isolates to 10 drugs: amphotericin (AMB), anidulafungin (AFG), caspofungin (CAS), micafungin (MFG), fluconazole (FLZ), voriconazole (VRZ), itraconazole (ITZ), posaconazole (POZ), 5-flucytosine (FCY), and isaconazole (ISA). In total, 884 C. parapsilosis species complex isolates were gathered between January 2005 and December 2020. C. parapsilosis, Candida metapsilosis, and Candida orthopsilosis accounted for 86.3, 8.1, and 5.5% of the cryptic species, respectively. The resistance/non-wild-type rate of bloodstream C. parapsilosis to the drugs was 3.5%, of C. metapsilosis to AFG and CAS was 7.7%, and of C. orthopsilosis to FLZ and VRZ was 15% and to CAS, MFG, and POZ was 5%. The geometric mean (GM) minimum inhibitory concentrations (MICs) of non-bloodstream C. parapsilosis for CAS (0.555 mg/L), MFG (0.853 mg/L), FLZ (0.816 mg/L), VRZ (0.017 mg/L), ITZ (0.076 mg/L), and POZ (0.042 mg/L) were significantly higher than those of bloodstream C. parapsilosis, for which the GM MICs were 0.464, 0.745, 0.704, 0.015, 0.061, and 0.033 mg/L, respectively (P < 0.05). The MIC distribution of the bloodstream C. parapsilosis strains collected from 2019 to 2020 for VRZ, POZ, and ITZ were 0.018, 0.040, and 0.073 mg/L, significantly higher than those from 2005 to 2018, which were 0.013, 0.028, and 0.052 mg/L (P < 0.05). Additionally, MIC distributions of C. parapsilosis with FLZ and the distributions of C. orthopsilosis with ITZ and POZ might be higher than those in Clinical and Laboratory Standards Institute studies. Furthermore, a total of 143 C. parapsilosis complex isolates showed great susceptibility to ISA. Overall, antifungal treatment of the non-bloodstream C. parapsilosis complex isolates should be managed and improved. The clinicians are suggested to pay more attention on azoles usage for the C. parapsilosis complex isolates. In addition, establishing the epidemiological cutoff values (ECVs) for azoles used in Eastern China may offer better guidance for clinical treatments. Although ISA acts on the same target as other azoles, it may be used as an alternative therapy for cases caused by FLZ- or VRZ-resistant C. parapsilosis complex strains.https://www.frontiersin.org/articles/10.3389/fmicb.2021.644000/fullantifungal susceptibilityCandida parapsilosisCandida metapsilosisCandida orthopsilosisChina |