ORIGINAL RESEARCH article
Front. Microbiol.
Sec. Antimicrobials, Resistance and Chemotherapy
Volume 16 - 2025 | doi: 10.3389/fmicb.2025.1616013
This article is part of the Research TopicEmerging Antimicrobials: Sources, Mechanisms of Action, Spectrum of Activity, Combination Antimicrobial Therapy, and Resistance MechanismsView all 32 articles
The prevalence, patterns, and resistance to antifungal drugs of bloodstream infection-causing fungi in Sichuan Province, China, 2019-2023: A retrospective observational study using national monitoring data
Provisionally accepted
- 1Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
- 2Clinical Laboratory Medicine Research Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
- 3Sichuan Clinical Research Center for Laboratory Medicine, Chengdu, Sichuan Province, China
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Background: The rising global burden of invasive fungal infections and expanding antifungal resistance pose critical public health threats. Using multicenter surveillance data from Sichuan Province, we conducted the largest and over a five-year period study of fungemia to date, aiming to understand the regional differences in the distribution and resistance of fungal pathogens.Methods: Retrospective analysis of fungal bloodstream infections (BSIs) from 31 hospitals (2019)(2020)(2021)(2022)(2023). Integrated clinical and laboratory data were analyzed using WHONET 5.6 for resistance patterns and Microsoft Excel (with PivotTable functionality) for epidemiological trends.Results: Annual fungal isolations increased steadily. Candida species comprised 88.7%(1,805/2,034) of bloodstream isolates, predominantly C. albicans (38.4%, 694/1,805). Patients were predominantly male (58.6%, 1,191/2,034) and ≥46 years old (80.0%, 1,627/2,034), with Intensive Care Units (ICUs) cases representing 36.8% (748/2,034). C. albicans showed highest fluconazole susceptibility (91.2%, 633/694). Both C. albicans and C. parapsilosis complex maintained >80% voriconazole susceptibility, followed by voriconazole wild-type C. glabrata complex (69.3%). C. tropicalis exhibited high resistance to fluconazole (36.2%, 21/58) and voriconazole (34.8%, 20/58). Cryptococcus spp. displayed non-wild-type rates to amphotericin B (8.7%), flucytosine (5.8%), fluconazole (8.7%), voriconazole (8.0%), and itraconazole (4.1%).Different types of hospitals isolated various fungi. While C. albicans predominated in 83.9% (26/31) of hospitals, pediatric specialty centers exhibited distinct microbiological profiles, with the highest isolations of the C. parapsilosis complex (χ²=18.34, P=0.002). Conclusions: Our research, which was conducted in several centers, revealed significant geographic variations in fungal disease spread and antifungal resistance. It is important to understand local epidemiology in order to guide antifungal therapy and enhance stewardship programs.
Keywords: ：fungal bloodstream infections, antifungal susceptibility, Distribution characteristics, 28 epidemiology, public health 29
Received: 29 Apr 2025; Accepted: 16 Jun 2025.
Copyright: © 2025 Deng, Liu, Shu, Zhou, Xie, Ma and Kang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ying Ma, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
Mei Kang, Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, China
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