Abstract：
Introduction. The Candida parapsilosis complex can be divided into C. parapsilosis sensu stricto, C. orthopsilosis, and C. metapsilosis subtypes. It is uncommon for drug sensitivity tests to type them.Gap Statement. In routine susceptibility reports, drug susceptibility of C. parapsilosis complex subtypes is lacking.Aim. The aim of this study is to investigate the antifungal susceptibility and clinical distribution characteristics of the C. parapsilosis complex subtypes causing deep infection in patients.Methodology. Non-repetitive strains of C. parapsilosis complex isolated from deep infection from 2017 to 2019 were collected. Species-level identification was performed using a matrix-assisted laser desorption/ionization time-of-flight mass spectrometer and confirmed using ITS gene sequencing, when necessary. Antifungal susceptibility testing was performed using the Sensititre YeastOne system method.Results. A total of 244 cases were included in the study, including 176 males (72.13 %, 60.69±13.43 years) and 68 females (27.87 %, 60.21±10.59 years). The primary diseases were cancer (43.44 %), cardiovascular disease (25.00 %), digestive system diseases, (18.44 %), infection (6.97 %), and nephropathy (6.15 %). Strains were isolated from the bloodstream (63.11 %), central venous catheters (15.16 %), pus (6.56 %), ascites (5.74 %), sterile body fluid (5.33 %), and bronchoalveolar lavage fluid (BALF, 4.09 %). Of the 244 C. parapsilosis complex strains, 179 (73.26 %) were identified as C. parapsilosis sensu stricto, 62 (25.41 %) were C. orthopsilosis, and three (1.23 %) were C. metapsilosis. Only one C. parapsilosis sensu stricto strain was resistant to anidulafungin, micafungin, caspofungin, and voriconazole, and it was non-wild-type (NWT) to amphotericin B. Furthermore, six C. parapsilosis sensu stricto strains were resistant to fluconazole, and one was dose-dependent susceptible. Five C. parapsilosis sensu stricto strains were NWT to posaconazole. Only one C. orthopsilosis strain was NWT for anidulafungin, micafungin, caspofungin, fluconazole, voriconazole, amphotericin B, and posaconazole, while the rest of the strains were wild-type.Conclusion. C. parapsilosis sensu stricto was the main clinical isolate from the C. parapsilosis complex in our hospital. Most strains were isolated from the bloodstream. The susceptibility rate to commonly used antifungal drugs was more than 96 %. Furthermore, most of the infected patients were elderly male cancer patients.
摘要：
Introduction.近平滑念珠菌复合体可分为严格的近平滑念珠菌，C.骨科,和C.metapsilosis亚型。药物敏感性试验对它们进行分型并不常见。差距声明。在常规敏感性报告中，近平滑梭菌复杂亚型的药物敏感性缺乏。瞄准.本研究的目的是调查引起患者深部感染的近apsilions复合亚型的抗真菌敏感性和临床分布特征。方法论。收集2017年至2019年从深部感染中分离出的非重复菌株。使用基质辅助激光解吸/电离飞行时间质谱仪进行物种水平鉴定，并使用ITS基因测序进行确认，必要时。使用SensistitreYeastOne系统方法进行抗真菌药敏试验。结果。共有244例病例被纳入研究，包括176名男性(72.13%，60.69±13.43岁）和68名女性（27.87%，60.21±10.59年）。原发疾病为癌症（43.44%），心血管疾病（25.00%），消化系统疾病，（18.44%），感染（6.97%），肾病（6.15%）。从血液中分离出菌株(63.11%)，中心静脉导管（15.16%），脓液(6.56%)，腹水（5.74%），无菌体液（5.33%），和支气管肺泡灌洗液（BALF，4.09%）。在244个近平滑梭菌复合体菌株中，179例(73.26%)被鉴定为严格感觉梭菌，62例(25.41%)为拟态梭菌，和三个（1.23％）是念珠菌。只有一种严格的近感觉梭菌菌株对anidulafungin具有抗性，米卡芬净,卡波芬金,和伏立康唑,两性霉素B是非野生型(NWT)。此外，6株对氟康唑耐药，一个是剂量依赖性易感。5株副感觉梭菌为NWT对泊沙康唑的菌株。只有一种拟态梭菌菌株是阿尼达芬净的NWT，米卡芬净,卡波芬金,氟康唑,伏立康唑,两性霉素B,和泊沙康唑,而其余菌株为野生型。结论。重症梭菌是我院近梭菌的主要临床分离株。大多数菌株是从血液中分离出来的。对常用抗真菌药物的敏感率达96%以上。此外，大多数感染患者是老年男性癌症患者。
