首页|2017-2023年华东地区近平滑念珠菌复合群临床分离株耐药特征分析

2017-2023年华东地区近平滑念珠菌复合群临床分离株耐药特征分析

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目的 监测华东地区近平滑念珠菌复合群(CPC)临床分离株对抗真菌药物的耐药性.方法 收集2017年1月—2023年12月华东地区47家医院CPC临床分离株,由同济大学附属东方医院南院检验科作为参考实验室,采用质谱法复核鉴定结果,采用微量肉汤稀释法检测菌株对10种临床常用抗真菌药物的最低抑菌浓度(MIC).依据2022年美国临床实验室标准化学会(CLSI)M27-M44s和M57s文件判断体外药物敏感性试验结果.结果 共收集CPC菌株941株,其中近平滑念珠菌783株(83.21%)、似平滑念珠菌96株(10.20%)、拟平滑念珠菌62株(6.59%).近平滑念珠菌对氟康唑和伏立康唑的耐药率分别为12.80%和3.50%;拟平滑念珠菌氟康唑和伏立康唑非野生型菌株分别为39.6%和37.7%;似平滑念珠菌卡泊芬净、氟康唑和伏立康唑非野生型菌株分别为14.0%、9.3%和12.8%.艾沙康唑对3种真菌的MIC众数均为0.008 mg·L-1,明显低于其他9种抗真菌药物.结论 华东地区CPC临床分离株对常用抗真菌药物的耐药性有一定差异,近平滑念珠菌和拟平滑念珠菌对氟康唑和伏立康唑的耐药率较高.CPC菌株对艾沙康唑的MIC值均较低,艾沙康唑可用于治疗多耐药CPC感染.
Drug resistance in clinical isolates of Candida parapsilosis species complex in eastern China region from 2017 to 2023
Objective To monitor the drug resistance of clinical isolates of Candida parapsilosis species complex(CPC)in eastern China region.Methods CPC isolates were isolated from 47 hospitals in eastern China region from January 2017 to December 2023.The reference laboratory was the Department of Clinical Laboratory of Shanghai East Hospital(South Branch)of Tongji University.The minimum inhibitory concentrations(MIC)of the isolates against 10 antifungal drugs were determined by microbroth dilution method.The in vitro drug susceptibility test results were analyzed according to the Clinical and Laboratory Standards Institute(CLSI)M27M44s and M57s documents.Results A total of 941 isolates of CPC were collected.The proportions of different CPC were as follows:Candida parapsilosis(83.21%,783 isolates),Candida orthopsilosis(10.20%,96 isolates)and Candida metapsilosis(6.59%,62 isolates).The drug resistance rates of Candida parapsilosis to fluconazole and voriconazole were 12.80%and 3.50%,respectively.The non-wild-type Candida metapsilosis to fluconazole and voriconazole were 39.6%and 37.7%,respectively.Non-wild-type Candida orthopsilosis showed 14.0%,9.3%and 12.8%to caspofungin,fluconazole and voriconazole,respectively.The MIC of isavuconazole against CPC was 0.008 mg·L-1,which was lower than the other 9 antifungal drugs.Conclusions There is a certain difference in the resistance of CPC to the tested antifungal drugs.Candida parapsilosis and Candida metapsilosis have higher resistance rates to fluconazole and voriconazole.All the isolates have low MIC for isavuconazole and can be recommended as first-line drugs for antifungal therapy.

Candida orthopsilosisCandida parapsilosisCandida metapsilosisIn virto drug susceptibilty testEastern China region

王东江、胡靓、郭建、李腾、田文杰、杨思敏、张旻、林慧萍、万菲菲、王子文、周爱萍

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同济大学附属东方医院南院检验科,上海 200123

同济大学医学院,上海 200092

似平滑念珠菌 近平滑念珠菌 拟平滑念珠菌 体外药物敏感性试验 华东地区

2024

检验医学
上海市临床检验中心

检验医学

CSTPCD
影响因子:1.715
ISSN:1673-8640
年,卷(期):2024.39(12)