In Vitro Antifungal Activity of Azoles and Other Antifungal Agents Against Pathogenic Yeasts from Vulvovaginal Candidiasis in China
作者全名："Kan, Siyue; Song, Nana; Pang, Qiuyu; Mei, Huan; Zheng, Hailin; Li, Dongmei; Cui, Fan; Lv, Guixia; An, Ruifang; Li, Ping; Xiong, Zhengai; Fan, Shangrong; Zhang, Mengzhen; Chen, Yanhong; Qiao, Qiao; Liang, Xudong; Cui, Manhua; Li, Dongyan; Liao, Qinping; Li, Xiaofang; Liu, Weida"
作者地址："[Song, Nana; Mei, Huan; Zheng, Hailin; Lv, Guixia; Li, Xiaofang; Liu, Weida] Chinese Acad Med Sci & Peking Union Med Coll, Inst Dermatol, Nanjing 210042, Peoples R China; [Kan, Siyue] Tongji Univ, Shanghai Skin Dis Hosp, Dept Med Mycol, Sch Med, Shanghai 200443, Peoples R China; [Pang, Qiuyu] Sichuan Univ, West China Hosp, Regenerat Med Res Ctr, Chengdu 610041, Peoples R China; [Zheng, Hailin; Li, Xiaofang; Liu, Weida] Jiangsu Key Lab Mol Biol Skin Dis & STIs, Nanjing 210042, Jiangsu, Peoples R China; [Li, Dongmei] Georgetown Univ, Dept Microbiol Immunol, Washington, DC 20057 USA; [Cui, Fan] Univ Elect Sci & Technol China, Sichuan Acad Med Sci & Sichuan Prov Peoples Hosp, Sch Med, 32,Western 2nd Sect,1st Ring Rd, Chengdu, Sichuan, Peoples R China; [An, Ruifang] Xi An Jiao Tong Univ, Affiliated Teaching Hosp 1, Xian 710061, Peoples R China; [Li, Ping] Nanjing Med Univ, Nanjing Matern & Child Hlth Care Hosp, Womens Hosp, Nanjing 210004, Peoples R China; [Xiong, Zhengai] Chongqing Med Univ, Affiliated Hosp 2, Chongqing 400010, Peoples R China; [Fan, Shangrong] Peking Univ, Shenzhen Hosp, Shenzhen 518035, Peoples R China; [Zhang, Mengzhen] Zhengzhou Univ, Affiliated Hosp 1, Zhengzhou 450052, Peoples R China; [Chen, Yanhong] Guangzhou Med Univ, Affiliated Hosp 3, Guangzhou 510150, Peoples R China; [Qiao, Qiao] Inner Mongolia Med Univ, Affiliated Hosp, Hohhot 010050, Peoples R China; [Liang, Xudong] Peking Univ, Peoples Hosp, Beijing 100044, Peoples R China; [Cui, Manhua] Second Hosp Jilin Univ, Dept Obstet & Gynecol, Changchun 130041, Peoples R China; [Li, Dongyan] Shanxi Med Univ, Hosp 2, Taiyuan 030001, Peoples R China; [Liao, Qinping] Tsinghua Univ, Beijing Tsinghua Changgung Hosp, Sch Clin Med, Dept Obstet & Gynecol, Beijing 102218, Peoples R China; [Liu, Weida] Nanjing Med Univ, Ctr Global Hlth, Sch Publ Hlth, Nanjing 211166, Peoples R China"
通信作者："Li, XF; Liu, WD (通讯作者)，Chinese Acad Med Sci & Peking Union Med Coll, Inst Dermatol, Nanjing 210042, Peoples R China.; Liao, QP (通讯作者)，Tsinghua Univ, Beijing Tsinghua Changgung Hosp, Sch Clin Med, Dept Obstet & Gynecol, Beijing 102218, Peoples R China."
ESI学科分类：PLANT & ANIMAL SCIENCE
文献类型：Article; Early Access
关键词：Candida; Azoles; Antifungal susceptibility; Drug resistance; Vulvovaginal candidiasis
摘要："Background Vulvovaginal candidiasis (VVC) is a public health issue worldwide. Little is known of the optimal treatment of recurrent VVC (RVVC) has not been established. Objective Through the in vitro antifungal susceptibility profiling of VVC isolates, we hope to foster significant improvements in the control and treatment of this disease. Methods Candida isolates from VVC patients were collected from 12 hospitals in 10 cities across China. Species were identified by phenotype analysis and DNA sequencing. Species were identified by phenotype analysis and DNA sequencing. Susceptibilities to 11 drugs were determined by Clinical and Laboratory Standards Institute broth microdilution. Results 543 strains were isolated from those VVC patients enrolled in this study, of which, 15.7% were from RVVC. The most commonly identified species was C. albicans (460, 84.71%), and the most commonly non-albicans Candida spp. (NAC) was C. glabrata (47, 8.66%). NAC also included C. Krusei, Meyerozyma Guillermondii, Meyerozyma Caribbica, C. Tropicalis, C. Parapsilosis, and C. Nivariensis. Most C. albicans isolates were susceptible to caspofungin (99.8%), followed by fluconazole (92%) and voriconazole (82.6%). The proportion of C. albicans strains with wild type (WT) MICs that were susceptible to amphotericin B and caspofungin were 98%, followed by posaconazole at 95%, itraconazole at 86%, fluconazole at 74% and voriconazole at 54%. The fluconazole MICs for C. albicans were lower than those for NAC (P < 0.05), while the itraconazole MICs showing no significant difference (P > 0.05). The susceptible rate of uncomplicated VVC to fluconazole was 92%. The proportion of WT strains to fluconazole in RVVC was much lower than that in other types of VVC (67 vs. 77%, P < 0.05). However, the proportions of WT strains to itraconazole in RVVC was over 85%, which was much higher than that to fluconazole (87 vs. 67%, P < 0.05). Conclusions C. albicans was still the predominant pathogen for VVC in China, while C. glabrata was the main species in NAC. Fluconazole could still be used as an empirical treatment for uncomplicated VVC. However, fluconazole may not be the first choice for the therapy of RVVC. In such cases, itraconazole appears to be the more appropriate treatment. As for VVC caused by NAC, nonfluconazole drugs, such as itraconazole, may be a good choice."
基金机构：National Science and Technology Major Project [2018ZX10734404]; CAMS Initiative for Innovative Medicine [2016-I2M-3-021]; National Natural Science Foundation of China ; Basical Scientific Research Fund Projects of Chinese Academy of Medical Sciences [2018PT31013]; Nanjing Clinical Medicine Research Center Project 
基金资助正文："This study was supported by the National Science and Technology Major Project (No. 2018ZX10734404), the CAMS Initiative for Innovative Medicine (No. 2016-I2M-3-021), National Natural Science Foundation of China (No. 81573059), the Basical Scientific Research Fund Projects of Chinese Academy of Medical Sciences (No. 2018PT31013) and Nanjing Clinical Medicine Research Center Project (No.2019060001)."