Diagnostic accuracy
Is fluconazole-resistant Candida hiding in urine?
Open access · cc by · source: Europe PMC
Among 519 C. tropicalis isolates, 16.5% were fluconazole-resistant (91.9% also voriconazole-resistant); candiduria resistance jumped to 29.5% after 2012, earlier than invasive strains.
Study at a glance
- Design
- Other — 12-year laboratory surveillance of Candida tropicalis isolates from candiduria vs invasive infection, plus ERG11 sequencing of fluconazole-resistant strains
- N
- N=519 · 519 unique C. tropicalis isolates from 485 patients (2010–2021); 363 urine (69.9%) and 156 invasive (30.1%)
- Population
- Clinical C. tropicalis isolates from urine and invasive samples at a Beijing hospital laboratory
- Outcome
- Fluconazole/voriconazole resistance rates over time and ERG11 mutations (especially Y132F / A395T/W)
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Key findings
69.9% of isolates were from urine. Overall fluconazole resistance 16.5% (86/519). Candiduria resistance rose from 6.8% (2010–11) to 29.5% from 2012–13. ERG11 A395T/W reached 87.5–100% after 2014; Y132F isolates had MIC50 >256 μg/ml.
Methodology
Ran 12-year lab surveillance (2010–2021) of unique C. tropicalis from urine vs invasive sites, measured azole MICs, and sequenced ERG11 in fluconazole-resistant isolates.
Limitations
Candiduria often reflects colonization, so resistant urine isolates are not automatically invasive disease; single-center China data may not match other regions.
How this study connects
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