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<p>The incidence of infections by non-<i>albicans Candida</i> species, including <i>Pichia kudriavzevii</i> (formerly <i>Candida krusei</i>) has been increasing. <i>P. kudriavzevii</i> exhibits intrinsic resistance to fluconazole (FLU) and rapidly develops acquired resistance to other antifungals. However, large-scale epidemiological, antifungal susceptibility, and genotyping data from mainland China remain limited. We analyzed the clinical and laboratory data of 203 <i>P. kudriavzevii</i> isolates spanning from 2017 to 2023. In vitro antifungal susceptibility testing was performed by the Sensititre YeastOne microdilution method. The genotyping of <i>P. kudriavzevii</i> isolates was analysed by multilocus sequence typing (MLST). The results showed that <i>P. kudriavzevii</i> were predominantly isolated from sputum (132, 65.02%) and urine (21, 10.34%). Patients with <i>P. kudriavzevii</i> isolation were mainly from the Infectious Diseases Department (50, 24.63%), Intensive Care Unit (lCU) (45, 22.17%) and General Surgery (32, 15.76%), and the pathogen was highly prevalent in individuals over 60&#xa0;years old. All isolates exhibited intrinsic resistance to FLU. The resistance rate to voriconazole (VOR) was 9.4% (19/203), showing an increasing trend. 80 isolates (39.41%) were non-wild-type (NWT) to amphotericin B (AMB) and posaconazole (POS). Excluding FLU, 31 isolates (15.27%) exhibited a resistant or NWT phenotype to at least two distinct antifungal agent classes, and the MLST analysis of them revealed 16 distinct diploid sequence types (DST) profiles. Among these, ST195 (7, 22.6%) and ST268 (6, 19.4%) were the predominant genotypes associated with antifungal resistance, and 58.1% of the resistant sequence types exhibited resistance to VOR. Continuous monitoring of antifungal susceptibility and molecular typing is essential. This study provides valuable insights for managing <i>P. kudriavzevii</i> infections and guiding clinical treatment strategies.</p>

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Antifungal Susceptibility and Multilocus Sequence Typing of Pichia kudriavzevii (Candida krusei) from a Tertiary Hospital in Shanghai

  • 期刊论文

  • 发表日期：

    2026年3月6日

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  • Guo Chen,
  • Li Li,
  • Junhao Zhu,
  • Yixin Huang,
  • Jieyi Wan,
  • Demin Han,
  • Min Zhu

摘要

The incidence of infections by non-albicans Candida species, including Pichia kudriavzevii (formerly Candida krusei) has been increasing. P. kudriavzevii exhibits intrinsic resistance to fluconazole (FLU) and rapidly develops acquired resistance to other antifungals. However, large-scale epidemiological, antifungal susceptibility, and genotyping data from mainland China remain limited. We analyzed the clinical and laboratory data of 203 P. kudriavzevii isolates spanning from 2017 to 2023. In vitro antifungal susceptibility testing was performed by the Sensititre YeastOne microdilution method. The genotyping of P. kudriavzevii isolates was analysed by multilocus sequence typing (MLST). The results showed that P. kudriavzevii were predominantly isolated from sputum (132, 65.02%) and urine (21, 10.34%). Patients with P. kudriavzevii isolation were mainly from the Infectious Diseases Department (50, 24.63%), Intensive Care Unit (lCU) (45, 22.17%) and General Surgery (32, 15.76%), and the pathogen was highly prevalent in individuals over 60 years old. All isolates exhibited intrinsic resistance to FLU. The resistance rate to voriconazole (VOR) was 9.4% (19/203), showing an increasing trend. 80 isolates (39.41%) were non-wild-type (NWT) to amphotericin B (AMB) and posaconazole (POS). Excluding FLU, 31 isolates (15.27%) exhibited a resistant or NWT phenotype to at least two distinct antifungal agent classes, and the MLST analysis of them revealed 16 distinct diploid sequence types (DST) profiles. Among these, ST195 (7, 22.6%) and ST268 (6, 19.4%) were the predominant genotypes associated with antifungal resistance, and 58.1% of the resistant sequence types exhibited resistance to VOR. Continuous monitoring of antifungal susceptibility and molecular typing is essential. This study provides valuable insights for managing P. kudriavzevii infections and guiding clinical treatment strategies.