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首页> 外文期刊>Infection and Drug Resistance >Clinical characteristics of the first cases of invasive candidiasis in China due to pan-echinocandin-resistant Candida tropicalis and Candida glabrata isolates with delineation of their resistance mechanisms
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Clinical characteristics of the first cases of invasive candidiasis in China due to pan-echinocandin-resistant Candida tropicalis and Candida glabrata isolates with delineation of their resistance mechanisms

机译：描述了中国首例因泛棘皮动物抗性热带 Candida Tropicalis 和 glabrata 分离株引起的侵袭性念珠菌病的临床特征及其耐药机制

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Echinocandin antifungal agents have become the first-line therapy for invasive candidiasis (IC) in many countries. Despite their increasing use, resistance to this class of drug is, overall, still uncommon. Here, we report two patients from the People’s Republic of China with IC, one with infection caused by pan-echinocandin-resistant Candida tropicalis and the other by pan-echinocandin-resistant Candida glabrata . We also describe the mechanisms of drug resistance of these isolates. The echinocandin-resistant C. glabrata isolate was cultured from ascitic fluid of a 46-year-old male patient with intra-abdominal IC developing after surgery in 2012. This patient had had no prior antifungal exposure. The echinocandin-resistant C.?tropicalis isolate was cultured from chest drainage fluid of a 60-year-old female patient with severe coronary disease and lung infection. Prior to culture and identification of the isolate, the patient had received micafungin treatment for 19 days. Both isolates were cross-resistant to micafungin, anidulafungin, and caspofungin, with minimum inhibitory concentration values of ≥2 μg/mL. The amino acid substitution E655K was found adjacent to the FKS2 HS1 region of the C. glabrata isolate, while the substitution S80P were found in the FKS1 HS1 region of the C. tropicalis isolate. This report highlights the emergence of echinocandin resistance in two important non- albicans Candida species. Although the overall prevalence of echinocandin resistance is low in the People’s Republic of China, monitoring of antifungal susceptibility trends in all Candida species is warranted.
机译：Echinocandin抗真菌剂已成为许多国家侵袭性念珠菌病（IC）的一线治疗药物。尽管增加了使用量，但总体上对此类药物的抗药性仍很罕见。在这里，我们报道了两名来自中国的IC患者，其中一名感染是由耐全棘皮菌素的热带念珠菌引起的，另一例是由耐泛铁链素菌的光滑念珠菌引起的。我们还描述了这些菌株的耐药性机制。从2012年手术后出现腹内IC的46岁男性患者的腹水中培养出对棘皮菌素耐药的光滑毛状念珠菌分离株。该患者此前未曾接受过抗真菌治疗。从一名60岁患有严重冠心病和肺部感染的女性患者的胸腔引流液中培养出对棘球菌素具有抗性的C.?tropicalis分离株。在培养和鉴定分离物之前，患者接受了米卡芬净治疗19天。两种分离物对米卡芬净，阿尼芬净和卡泊芬净具有交叉耐药性，最小抑菌浓度值≥2μg/ mL。氨基酸取代E655K被发现与光滑念珠菌分离物的FKS2 HS1区域相邻，而取代S80P被发现于热带念珠菌分离物的FKS1 HS1区域。该报告强调了棘皮菌素抗性在两种重要的非白色念珠菌物种中的出现。尽管在中国，棘皮菌素耐药性的总体患病率较低，但有必要对所有念珠菌物种的抗真菌药性趋势进行监测。

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