Candida isolates causing refractory or recurrent oropharyngeal candidiasis in 11 hospitals in China

Shu-Ying Yu,1–3 Li Zhang,1,3 Sharon Chen,4 Fanrong Kong,4 Meng Xiao,1,3 He Wang,1,3 Xin Hou,1–3 Meng-Lan Zhou,1–3 Ge Zhang,1,3 Jing-Jia Zhang,1,3 Si-Meng Duan,1,3 Wei Kang,1,3 Ying-Chun Xu1,31Department of Clinical Laboratory, Peking Union Medical College Hospital, Chin...

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Main Authors: Yu SY, Zhang L, Chen S, Kong F, Xiao M, Wang H, Hou X, Zhou ML, Zhang G, Zhang JJ, Duan SM, Kang W, Xu YC
Format: Article
Language:English
Published: Dove Medical Press 2019-04-01
Series:Infection and Drug Resistance
Subjects:
Online Access:https://www.dovepress.com/candida-isolates-causing-refractory-or-recurrent-oropharyngeal-candidi-peer-reviewed-article-IDR
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author Yu SY
Zhang L
Chen S
Kong F
Xiao M
Wang H
Hou X
Zhou ML
Zhang G
Zhang JJ
Duan SM
Kang W
Xu YC
author_facet Yu SY
Zhang L
Chen S
Kong F
Xiao M
Wang H
Hou X
Zhou ML
Zhang G
Zhang JJ
Duan SM
Kang W
Xu YC
author_sort Yu SY
collection DOAJ
description Shu-Ying Yu,1–3 Li Zhang,1,3 Sharon Chen,4 Fanrong Kong,4 Meng Xiao,1,3 He Wang,1,3 Xin Hou,1–3 Meng-Lan Zhou,1–3 Ge Zhang,1,3 Jing-Jia Zhang,1,3 Si-Meng Duan,1,3 Wei Kang,1,3 Ying-Chun Xu1,31Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China; 2Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China; 3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, People’s Republic of China; 4Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR –New South Wales Health Pathology, The University of Sydney, Westmead, New South Wales, AustraliaIntroduction: We studied the species distribution and antifungal susceptibilities of Candida isolates causing refractory or recurrent oropharyngeal candidiasis (OPC) in a multicenter study in China (2013–2016).Methods: Species identification was performed using the Bruker Biotyper (Bruker Daltonics, Germany) matrix-assisted laser desorption/ionization time of flight mass spectrometry system supplemented by internal transcribed spacer sequencing as required. Antifungal susceptibilities were determined by the Clinical and Laboratory Standards Institute document (CLSI) M27-A3 broth microdilution methodology.Results: A total of 558 non-duplicate Candida isolates comprising 10 species were obtained from 535 patients. Candida albicans was the most common species (89.6%), followed by C. glabrata (5.2%), C. tropicalis (2.9%), and C. parapsilosis (0.7%). Azoles were active against C. albicans with susceptibility rates of 96% and 95.8% for fluconazole and voriconazole, respectively. MIC50 values of C. albicans to fluconazole, voriconazole, itraconazole, and miconazole were 1, 0.03, 0.25 and 0.12 μg/mL, respectively, higher than those in previous studies of which OPC patients (corresponding MIC50 values of 0.25 , 0.015 , 0.06 , and 0.03 μg/mL). Except for itraconazole, the MIC50 and MIC90 values of 58 non-C. albicans to other azoles were two to threefold higher than C. albicans. Miconazole, amphotericin B, nystatin, and 5-flucytosine had good in vitro antifungal activity for all isolates.Conclusion: The study provides valuable data on the species distribution and antifungal susceptibility of oropharyngeal Candida isolates from geographically diverse areas of China. C. albicans remains the most common species but with increasing rates of azoles resistance.Keywords: oral candidiasis, Candida, identification, antifungal susceptibility
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spelling doaj.art-0b75a153e79a4d23bdbbdbf9eff486992022-12-22T02:42:54ZengDove Medical PressInfection and Drug Resistance1178-69732019-04-01Volume 1286587545216Candida isolates causing refractory or recurrent oropharyngeal candidiasis in 11 hospitals in ChinaYu SYZhang LChen SKong FXiao MWang HHou XZhou MLZhang GZhang JJDuan SMKang WXu YCShu-Ying Yu,1–3 Li Zhang,1,3 Sharon Chen,4 Fanrong Kong,4 Meng Xiao,1,3 He Wang,1,3 Xin Hou,1–3 Meng-Lan Zhou,1–3 Ge Zhang,1,3 Jing-Jia Zhang,1,3 Si-Meng Duan,1,3 Wei Kang,1,3 Ying-Chun Xu1,31Department of Clinical Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China; 2Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, People’s Republic of China; 3Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases (BZ0447), Beijing, People’s Republic of China; 4Centre for Infectious Diseases and Microbiology Laboratory Services, ICPMR –New South Wales Health Pathology, The University of Sydney, Westmead, New South Wales, AustraliaIntroduction: We studied the species distribution and antifungal susceptibilities of Candida isolates causing refractory or recurrent oropharyngeal candidiasis (OPC) in a multicenter study in China (2013–2016).Methods: Species identification was performed using the Bruker Biotyper (Bruker Daltonics, Germany) matrix-assisted laser desorption/ionization time of flight mass spectrometry system supplemented by internal transcribed spacer sequencing as required. Antifungal susceptibilities were determined by the Clinical and Laboratory Standards Institute document (CLSI) M27-A3 broth microdilution methodology.Results: A total of 558 non-duplicate Candida isolates comprising 10 species were obtained from 535 patients. Candida albicans was the most common species (89.6%), followed by C. glabrata (5.2%), C. tropicalis (2.9%), and C. parapsilosis (0.7%). Azoles were active against C. albicans with susceptibility rates of 96% and 95.8% for fluconazole and voriconazole, respectively. MIC50 values of C. albicans to fluconazole, voriconazole, itraconazole, and miconazole were 1, 0.03, 0.25 and 0.12 μg/mL, respectively, higher than those in previous studies of which OPC patients (corresponding MIC50 values of 0.25 , 0.015 , 0.06 , and 0.03 μg/mL). Except for itraconazole, the MIC50 and MIC90 values of 58 non-C. albicans to other azoles were two to threefold higher than C. albicans. Miconazole, amphotericin B, nystatin, and 5-flucytosine had good in vitro antifungal activity for all isolates.Conclusion: The study provides valuable data on the species distribution and antifungal susceptibility of oropharyngeal Candida isolates from geographically diverse areas of China. C. albicans remains the most common species but with increasing rates of azoles resistance.Keywords: oral candidiasis, Candida, identification, antifungal susceptibilityhttps://www.dovepress.com/candida-isolates-causing-refractory-or-recurrent-oropharyngeal-candidi-peer-reviewed-article-IDROral candidiasisCandidaidentificationantifungal susceptibility
spellingShingle Yu SY
Zhang L
Chen S
Kong F
Xiao M
Wang H
Hou X
Zhou ML
Zhang G
Zhang JJ
Duan SM
Kang W
Xu YC
Candida isolates causing refractory or recurrent oropharyngeal candidiasis in 11 hospitals in China
Infection and Drug Resistance
Oral candidiasis
Candida
identification
antifungal susceptibility
title Candida isolates causing refractory or recurrent oropharyngeal candidiasis in 11 hospitals in China
title_full Candida isolates causing refractory or recurrent oropharyngeal candidiasis in 11 hospitals in China
title_fullStr Candida isolates causing refractory or recurrent oropharyngeal candidiasis in 11 hospitals in China
title_full_unstemmed Candida isolates causing refractory or recurrent oropharyngeal candidiasis in 11 hospitals in China
title_short Candida isolates causing refractory or recurrent oropharyngeal candidiasis in 11 hospitals in China
title_sort candida isolates causing refractory or recurrent oropharyngeal candidiasis in 11 hospitals in china
topic Oral candidiasis
Candida
identification
antifungal susceptibility
url https://www.dovepress.com/candida-isolates-causing-refractory-or-recurrent-oropharyngeal-candidi-peer-reviewed-article-IDR
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