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Five-Year National Surveillance of Invasive Candidiasis: Species Distribution and Azole Susceptibility from the China Hospital Invasive Fungal Surveillance Net (CHIF-NET) Study
Ist Teil von
Journal of clinical microbiology, 2018-07, Vol.56 (7)
Ort / Verlag
United States: American Society for Microbiology
Erscheinungsjahr
2018
Quelle
MEDLINE
Beschreibungen/Notizen
Data on the epidemiology of invasive candidiasis (IC) and the antifungal susceptibility of
isolates in China are still limited. Here we report on surveillance for IC from the China Hospital Invasive Fungal Surveillance Net (CHIF-NET) study. Sixty-five tertiary hospitals collected 8,829
isolates from 1 August 2009 to 31 July 2014. Matrix-assisted laser desorption ionization-time of flight mass spectrometry supplemented by ribosomal DNA sequencing was used to define the species, and the fluconazole and voriconazole susceptibilities were determined by the Clinical and Laboratory Standards Institute disk diffusion method. A total of 32
species were identified.
was the most common species (44.9%), followed by the
complex (20.0%),
(17.2%), and the
complex (10.8%), with other species comprising <3% of isolates. However, in candidemia, the proportion of cases caused by
was only 32.3%.
and
complex isolates were susceptible to fluconazole and voriconazole (<6% resistance), while fluconazole and azole cross-resistance rates were high in
(13.3% and 12.9%, respectively),
complex (18.7% and 14%, respectively), and uncommon
species (44.1% and 10.3%, respectively) isolates. Moreover, from years 1 to 5 of the study, there was a significant increase in the rates of resistance to fluconazole among
complex isolates (12.2% to 24.0%) and to both fluconazole (5.7% to 21.0%) and voriconazole (5.7% to 21.4%) among
isolates (
< 0.01 for all comparisons). Geographic variations in the causative species and susceptibilities were noted. Our findings indicate that antifungal resistance has become noteworthy in China, and enhanced surveillance is warranted.