Drug resistance and serological detection of Candida isolated from a fungal surveillance network in Hainan province from 2013 to 2022
Objective To collect data of fungi isolated from a fungus monitoring network in Hainan Province from 2013 to 2022,and analyze the drug resistance characteristics of Candida and the results of serological tests,with an aim to provide a basis for clinical diagnosis and treatment.Methods In accordance with the National Fungal Drug Resistance Monitoring Network technical scheme,the qualifying fungal data were extracted from the microbial identification system database using SQL language,and the data information was then analyzed,with statistical processing done using SPSS 26.0 software.Results Among 5 503 fungal isolates from clinical specimens between 2013 and 2022,cervical orifice secretions accounted for 30.37％(1 671 strains),mid-stream urine for 23.55％(1 296 strains),lower respiratory tract specimens for 25.24％(1 389 strains)[(sputum for 20.37％(l 121 strains)and alveolar lavage fluid for 4.87％(268 strains)],wound pus for 9.59％(528 strains),ascites for 5.60％(308 strains),blood for 3.67％(202 strains),cerebrospinal fluid for 0.38％(21 strains),and joint fluid for 0.04％(2 strains),with the highest number of strains isolated in 2022 and the lowest in 2013,the 2022 figure is about 2.6 times that of 2013.Among yeast-like fungi,Candida albicans had the highest proportion with 3 312 strains accounting for 60.2％;The highest resistance rate of Candida albicans was to fluconazole at 16.7％,with 2.5％being non-wild type(NWT)for amphotericin B;Candida tropicalis had the highest rate of resistance to fluconazole at 36.0％,with NWT at 41.1％for fluconazole and 3.1％for amphotericin B;Candida glabrata had a resistance rate to fluconazole of 2.8％,dose-dependent susceptibility(SDD)of 97.2％,NWT of 15.5％for fluconazole,and NWT of 8.6％for itraconazole;Candida parapsilosis had the highest resistance rate to fluconazole at 15.7％and and NWT of 8.3％for amphotericin B;Candida krusei had a 0.0％resistance rate to caspofungin;and Candida dubliniensis was 100.0％NWT to fluconazole.Of 70 cases of blood culture-positive specimens,64 cases were detected by G test and 25 cases by Mn test,and the positive blood cultures were statistically significant when compared with the G test and Mn test,respectively(P＜0.01).Conclusions Fungal serological test can make up for the deficiency of blood culture and distinguish fungal invasion and colonization,thus providing a basis for the effective control of fungal infection in clinical practice.
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