Fungal resistance surveillance report in East China in 2025

doi:10.16150/j.1671-2870.2026.03.005

Journal of Diagnostics Concepts & Practice ›› 2026, Vol. 25 ›› Issue (03): 287-307.doi: 10.16150/j.1671-2870.2026.03.005

• Original articles • Previous Articles Next Articles

Fungal resistance surveillance report in East China in 2025

LIN Huiping¹, WANG Dongjiang¹, GUO Jian¹, LI Teng¹, YANG Simin¹, WANG Shasha¹, ZHOU Aiping¹, HU Liang¹, TIAN Wenjie¹, MA Zhexiao¹, WU Jiaqi¹, GULIZIBA Yalimaimaiti¹, ZHANG Yan², CHEN Hui³, XIAO Chenlu⁴, GUO Wei⁵, WANG Suzhen⁵, WAN Zhimin⁶, HAN Chunhua⁷, WANG Shenghua⁸, WEN Kaizhen⁹, LI Bin¹⁰, CHEN Yanlin¹⁰, XIE Yuping¹⁰, CHEN Wenjing¹¹, MENG Hongwei¹², LI Zhifu¹², XU Heping¹³, HE Lei¹⁴, WEI Muyun¹⁴, LI Tinghua¹⁴, YANG Haihui¹⁴, XI Wei¹⁴^,¹⁵, WU Yongqin¹⁶, LU Huaiwei¹⁶, ZHUANG Yihui¹⁷, LIU Yan¹⁸, SHEN Dandan¹⁸, QIN Jie¹⁹, LI Shengchao²⁰, YANG Qing²⁰, HUANG Jingjing²¹, TANG Chaogui²¹, XU Jie²², REN Jianmin²³, LIU Shufen²⁴, HU Xiuhua²⁴, SHANG Anquan²⁵, YUAN Yiqun²⁶, ZHOU Ling²⁷, DENG Weiping²⁷, CHEN Sijia²⁸, HU Haiqing²⁹, LU Xiuhai³⁰, HU Yongqi³¹, LI Zhilan³², DAI Yun³³, HU Niya³⁴, ZENG Lingbing³⁴, QIAN Minjian³⁵, HUANG Xiaochun³⁶, PAN Fen³⁷, JIANG Na³⁸, HU Juan³⁹, ZHU Zhaoqin⁴⁰, JIN Ying⁴¹, YANG Leyuan⁴², LIU Huaiyu⁴³, LI Niya⁴³^,⁴⁴, WENG Lizhen⁴⁵, XIA Yilan⁴⁵, LI Na⁴⁶, GAO Jing⁴⁷, ZHANG Xiaoxue⁴⁸, LIU Yun⁴⁹, CHEN Xu⁵⁰, DAI Junhua⁵¹, LIU Jun⁵², QIAN Duoduo⁵³, HOU Weiwei⁵⁴, WANG Yueling⁵⁵, SUN Jingfang⁵⁶, HUANG Lili⁵⁷, SHU Wen⁵⁸, LI Li⁵⁹, SHI Jianying⁶⁰, ZHANG Haomin⁶¹, LIU Chunhong⁶², YANG Weihua⁶³, WANG Fang⁶⁴, WU Wenjuan¹()

1 Department of Clinical Laboratory, South Campus of Shanghai East Hospital (The Affiliated East Hospital of Tongji University), Shanghai 200123, China
2 Department of Clinical Laboratory, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing 210008, Jiangsu, China
3 Department of Clinical Laboratory, Jiangxi Provincial People's Hospital, Nanchang 330000, Jiangxi, China
4 Department of Clinical Laboratory, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
5 Department of Clinical Laboratory, Zhongshan Hospital Affiliated to Fudan University, Shanghai 200032, China
6 Department of Clinical Laboratory, Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha 410005, Hunan, China
7 Department of Clinical Laboratory, The Affiliated Hospital of Qingdao University, Qingdao 266000, Shandong, China
8 Department of Clinical Laboratory, Central Campus of Shandong Provincial Hospital, Jinan 250021, Shandong, China
9 Department of Clinical Laboratory, Jinjiang Hospital of Fujian Province, Jinjiang 362200, Fujian, China
10 Department of Clinical Laboratory, Union Hospital Affiliated to Fujian Medical University, Fuzhou 350001, Fujian, China
11 Department of Clinical Laboratory, Shanghai General Hospital, Shanghai 200080, China
12 Department of Clinical Laboratory, Shanghai Chest Hospital, Shanghai 200030, China
13 Department of Clinical Laboratory, The First Affiliated Hospital of Xiamen University, Xiamen 361003, Fujian, China
14 Department of Clinical Laboratory, West Campus of Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200001, China
15 Department of Clinical Laboratory, South Campus of Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 201112, China
16 Department of Clinical Laboratory, The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital), Hefei 230001, Anhui, China
17 Department of Clinical Laboratory, Fudan University Shanghai Cancer Center, Shanghai 200032, China
18 Department of Clinical Laboratory, Shanghai Tenth People's Hospital, Shanghai 200072, China
19 Department of Clinical Laboratory, Children's Hospital of Fudan University, Shanghai 201102, China
20 Department of Clinical Laboratory, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang, China
21 Department of Clinical Laboratory, The First People's Hospital of Huai'an, Huai'an 223300, Jiangsu, China
22 Department of Clinical Laboratory, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China
23 Department of Clinical Laboratory, Lishui Central Hospital of Zhejiang Province, Lishui 323000, Zhe-jiang, China
24 Department of Clinical Laboratory, Zhoupu Hospital of Pudong New Area, Shanghai 201318, China
25 Department of Clinical Laboratory, The Second People's Hospital of Lianyungang, Lianyungang 222023, Jiangsu, China
26 Department of Clinical Laboratory, Jinshan Hospital Affiliated to Fudan University, Shanghai 201508, China
27 Department of Clinical Laboratory, Shanghai Pudong Hospital, Shanghai 201399, China
28 Department of Clinical Laboratory, Eastern Hepatobiliary Surgery Hospital, Shanghai 200438, China
29 Department of Clinical Laboratory, The Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital), Shanghai 200003, China
30 Department of Clinical Laboratory, Shandong Eye Hospital, Jinan 250021, Shandong, China
31 Department of Clinical Laboratory, Shanghai Tongren Hospital, Shanghai 200336, China
32 Department of Clinical Laboratory, Shanghai Seventh People's Hospital, Shanghai 200137, China
33 Department of Clinical Laboratory, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200021, China
34 Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi, China
35 Department of Clinical Laboratory, Chongming Hospital Affilia-ted to Shanghai University of Medicine and Health Sciences, Shanghai 202150, China
36 Department of Clinical Laboratory, Changhai Hospital, Shanghai 200433, China
37 Department of Clinical Laboratory, Shanghai Children's Hospital, Shanghai 200062, China
38 Department of Clinical Laboratory, Gongli Hospital of Pudong New Area, Shanghai 200135, China
39 Department of Clinical Laboratory, The Fifth People's Hospital of Shanghai, Shanghai 200240, China
40 Department of Clinical Laboratory, Shanghai Public Health Clinical Center, Shanghai 200083, China
41 Department of Clinical Laboratory, South Campus of Punan Hospital of Pudong New Area, Shanghai 200125, China
42 Department of Clinical Laboratory, Baoshan Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai 201999, China
43 Department of Clinical Laboratory, Shanghai Sixth People's Hospital, Shanghai 200233, China
44 Department of Clinical Laboratory, Lingang Campus of Shanghai Sixth People's Hospital, Shanghai 201306, China
45 Department of Clinical Laboratory, Jing'an District Central Hospital of Shanghai, Shanghai 200040, China
46 Department of Clinical Laboratory, Naval Special Medical Center of PLA, Shanghai 200052, China
47 Department of Clinical Laboratory, Obstetrics and Gynecology Hospital Affiliated to Fudan University, Shanghai 200090, China
48 Department of Clinical Laboratory, People's Hospital of Pudong New Area, Shanghai 201299, China
49 Department of Clinical Laboratory, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
50 Department of Clinical Laboratory, The Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
51 Department of Clinical Laboratory, Putuo District Central Hospital of Shanghai, Shanghai 200333, China
52 Department of Clinical Laboratory, Songjiang District Central Hospital of Shanghai, Shanghai 201600, China
53 Department of Clinical Laboratory, Yangpu District Central Hospital of Shanghai, Shanghai 200090, China
54 Department of Clinical Laboratory, Tongji Hospital of Shanghai, Shanghai 200065, China
55 Department of Clinical Laboratory, East Campus of Shandong Provincial Hospital, Jinan 250014, Shandong, China
56 Department of Clinical Laboratory, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu, China
57 Department of Clinical Laboratory, Children's Hospital of Soochow University, Suzhou 215025, Jiangsu, China
58 Department of Clinical Laboratory, South Campus of Shanghai General Hospital, Shanghai 201620, China
59 Department of Clinical Laboratory, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
60 Department of Clinical Laboratory, Jiading District Central Hospital of Shanghai, Shanghai 201800, China
61 Department of Clinical Laboratory, East Campus of Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
62 Department of Clinical Laboratory, Eye and ENT Hospital Affiliated to Fudan University, Shanghai 200031, China
63 Department of Clinical Laboratory, Zhabei Central Hospital of Jing'an District, Shanghai 200070, China
64 Department of Clinical Laboratory, Qingpu Campus of Zhongshan Hospital Affiliated to Fudan University, Shanghai 201700, China

Received:2026-03-02 Revised:2026-05-13 Accepted:2026-05-18 Online:2026-06-25 Published:2026-06-27
Contact: WU Wenjuan E-mail:wwj1210@126.com

Abstract

Abstract:

Objective This study aims to monitor the antifungal susceptibility of clinically isolated fungi in East China in 2025, thereby providing a reference for clinical diagnosis and treatment. Methods A retrospective analysis was conducted on clinical fungi collected by the East China Invasive Fungal Infection Group (ECIFIG) from January to December 2025. Species identification was performed using morphological characteristics combined with mass spectrometry, and the results were verified by internal transcribed spacer (ITS) sequencing and β-tubulin gene sequencing. Antifungal susceptibility testing for azoles (fluconazole, itraconazole, voriconazole, posaconazole, isavuconazole), echinocandins (micafungin, anidulafungin, caspofungin), amphotericin B, and flucytosine was carried out using the broth microdilution method. Results In 2025, a total of 2 044 yeast isolates were collected in East China, and blood was the primary specimen type, accounting for 37.06% (763/2 044). The yeast species distribution was as follows: Candida albicans 38.51% (793/2 044), Candida tropicalis 18.89% (389/2 044), Candida parapsilosis 16.61% (342/2 044), Candida glabrata 15.20% (313/2 044), and Candida krusei 1.75% (36/2 044). A total of 310 filamentous fungal isolates were collected in East China, predominantly Aspergillus species: Aspergillus fumigatus (62.26%), Aspergillus flavus (26.45%), Aspergillus niger (5.81%), and Aspergillus terreus (3.55%). Filamentous fungi were mainly isolated from respiratory specimens, with sputum specimen accounting for 53.23% and bronchoalveolar lavage fluid (BALF) specimen accounting for 31.29%. Resistance in Candida species was primarily observed for azoles. The fluconazole resistance rate in C. albicans was 3.66%, and the rate of non-wild-type (NWT) isolates for posaconazole was 6.81%. For C. tropicalis, the fluconazole resistance rate was 29.05%, the voriconazole non-susceptible rate was 24.45%, the itraconazole NWT rate was 17.48%, and the posaconazole NWT rate was 61.18%. C. parapsilosis showed a fluconazole resistance rate of 11.7% and an amphotericin B NWT rate of 2.30%. C. glabrata exhibited a fluconazole resistance rate of 5.75%, and the NWT rates for itraconazole, posaconazole, and voriconazole were 1.92%, 12.78%, and 28.12%, respectively. For A. fumigatus, the voriconazole intermediate rate was 3.63%, and the resistance rate was 5.18%. The isavuconazole intermediate rate was 1.04%, the resistance rate was 4.70%, and the NWT rate for itraconazole was 3.11%. All A. flavus isolates were wild-type for caspofungin, amphotericin B, and azoles. Conclusions In 2025, East China Fungal Surveillance Network collects 2 044 yeast isolates, primarily from blood specimens, with C. albicans being the most prevalent. A total of 310 filamentous fungal isolates are collected, mainly from respiratory specimens, with A. fumigatus being the most common. Azole resistance in C. tropicalis is significantly higher than that in other Candida species. The azole resistance rate in A. fumigatus is 5.18%, showing an increase compared to it in previous years. No azole-resistant A. flavus isolates have been detected.

Key words: East China, Fungal resistance surveillance, Invasive fungal infection, Antifungal susceptibility testing

CLC Number:

R446
R519

LIN Huiping, WANG Dongjiang, GUO Jian, LI Teng, YANG Simin, WANG Shasha, ZHOU Aiping, HU Liang, TIAN Wenjie, MA Zhexiao, WU Jiaqi, GULIZIBA Yalimaimaiti, ZHANG Yan, CHEN Hui, XIAO Chenlu, GUO Wei, WANG Suzhen, WAN Zhimin, HAN Chunhua, WANG Shenghua, WEN Kaizhen, LI Bin, CHEN Yanlin, XIE Yuping, CHEN Wenjing, MENG Hongwei, LI Zhifu, XU Heping, HE Lei, WEI Muyun, LI Tinghua, YANG Haihui, XI Wei, WU Yongqin, LU Huaiwei, ZHUANG Yihui, LIU Yan, SHEN Dandan, QIN Jie, LI Shengchao, YANG Qing, HUANG Jingjing, TANG Chaogui, XU Jie, REN Jianmin, LIU Shufen, HU Xiuhua, SHANG Anquan, YUAN Yiqun, ZHOU Ling, DENG Weiping, CHEN Sijia, HU Haiqing, LU Xiuhai, HU Yongqi, LI Zhilan, DAI Yun, HU Niya, ZENG Lingbing, QIAN Minjian, HUANG Xiaochun, PAN Fen, JIANG Na, HU Juan, ZHU Zhaoqin, JIN Ying, YANG Leyuan, LIU Huaiyu, LI Niya, WENG Lizhen, XIA Yilan, LI Na, GAO Jing, ZHANG Xiaoxue, LIU Yun, CHEN Xu, DAI Junhua, LIU Jun, QIAN Duoduo, HOU Weiwei, WANG Yueling, SUN Jingfang, HUANG Lili, SHU Wen, LI Li, SHI Jianying, ZHANG Haomin, LIU Chunhong, YANG Weihua, WANG Fang, WU Wenjuan. Fungal resistance surveillance report in East China in 2025[J]. Journal of Diagnostics Concepts & Practice, 2026, 25(03): 287-307.

Figures/Tables 27

Table 1

List of isolates collected by member institutions of ECIFIG in 2025

Region	Hospital	No. of yeasts	No. of filamentous fungus	No. of total isolates
Shanghai	Ruijin Hospital, Shanghai Jiao Tong University School of Medicine	167	0	167
	Shanghai East Hospital, Tongji University School of Medicine	113	37	150
	Zhongshan Hospital, Fudan University	135	0	135
	Shanghai First People's Hospital	56	0	56
	Shanghai Chest Hospital	56	0	56
	Renji Hospital West Campus, Shanghai Jiao Tong University School of Medicine	41	0	41
	Fudan University Shanghai Cancer Center	39	0	39
	Shanghai Tenth People's Hospital	37	0	37
	Children's Hospital of Fudan University	34	0	34
	Shanghai First People's Hospital (South Campus)	29	0	29
	Ruijin Hospital North Campus, Shanghai Jiao Tong University School of Medicine	29	0	29
	Pudong Zhoupu Hospital	21	0	21
	Jinshan Hospital, Fudan University	16	0	16
	Shanghai Pudong Hospital	16	0	16
	Shanghai Eastern Hepatobiliary Surgery Hospital	15	0	15
	Shanghai Changzheng Hospital	14	0	14
	Jiading District Central Hospital	13	0	13
	Shanghai Tongren Hospital	11	0	11
	Renji Hospital (East Campus), Shanghai Jiao Tong University School of Medicine	10	0	10
	Shanghai Seventh People's Hospital	10	10	10
	Shuguang Hospital East Campus, Shanghai University of Traditional Chinese Medicine	10	0	10
	Shanghai University of Medicine & Health Sciences Affiliated Chongming Hospital	9	0	9
	Shanghai Changhai Hospital	9	0	9
	Shanghai Children's Medical Center	8	0	8
	Pudong New Area Gongli Hospital	8	0	8
	Shanghai Fifth People's Hospital	7	0	7
	Shanghai Public Health Clinical Center	7	0	7
	Punan Hospital South Campus, Pudong New Area, Shanghai	7	0	7
	Eye & ENT Hospital of Fudan University	6	0	6
	Baoshan District Integrated Traditional Chinese and Western Medicine Hospital	6	0	6
	Shanghai Sixth People's Hospital	6	0	6
	Jing'an District Central Hospital, Shanghai	6	0	6
	PLA Naval Specialized Medical Center	5	0	5
	Obstetrics and Gynecology Hospital of Fudan University	4	0	4
	Pudong New Area People's Hospital	4	0	4
	Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine	4	0	4
	Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine	3	0	3
	Zhabei Central Hospital, Jing'an District	3	0	3
	Putuo District Central Hospital	3	0	3
	Songjiang District Central Hospital	3	0	3
	Yangpu District Central Hospital	3	0	3
	Shanghai Tongji Hospital	2	0	2
	Zhongshan Hospital Qingpu Branch, Fudan University	1	0	1
	Renji Hospital South Campus, Shanghai Jiao Tong University School of Medicine	1	0	1
	Shanghai Sixth People's Hospital Lingang Campus	1	0	1
Jiangsu Province	Affiliated Drum Tower Hospital, Medical School of Nanjing University	209	100	309
	The Affiliated Hospital of Xuzhou Medical University	47	0	47
	Suzhou Children's Hospital, Affiliated to Soochow University	43	0	43
	The First People's Hospital of Huai'an	29	0	29
	The First Affiliated Hospital of Soochow University	26	0	26
	The Second People's Hospital of Lianyungang	17	0	17
Jiangxi Province	Jiangxi Provincial People's Hospital	126	109	235
	The First Affiliated Hospital of Nanchang University	9	0	9
Shandong Province	Qingdao University Affiliated Hospital	99	5	104
	Shandong Provincial Hospital Affiliated to Shandong University (Central Campus)	81	0	81
	Shandong Provincial Hospital Affiliated to Shandong University (East Campus)	39	2	41
	Shandong Provincial Eye Hospital	0	12	12
Fujian Province	Jinjiang City Hospital	22	45	67
	Fujian Medical University Union Hospital	58	0	58
	The First Affiliated Hospital of Xiamen Medical University	44	0	44
Hunan Province	Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University)	105	0	105
Zhejiang Province	The First Affiliated Hospital, Zhejiang University School of Medicine (Zhijiang Campus)	34	0	34
	Lishui Central Hospital	24	0	24
Anhui Province	The First Affiliated Hospital of USTC (Anhui Provincial Hospital)	39	0	39

Table 1

Table 2

Table 3

Table 4

Table 5

Table 6

Table 7

Table 8

Table 9

Table 10

Table 11

Table 12

Table 13

Table 14

Table 15

Table 16

Table 17

Table 18

Table 19

Table 20

Susceptibility analysis of other clinically isolated yeasts to common antifungal agents（n=24）

Species	Antifungal agents	MIC range (µg/mL)	MIC₅₀ (µg/mL)	MIC₉₀ (µg/mL)
Candida fermentati (n=4)	Anidulafungin	0.06-2	0.5	1
	Caspofungin	0.12-0.5	0.5	0.5
	Micafungin	0.03-2	0.25	2
	Fluconazole	2-256	4	256
	Voriconazole	0.06-8	0.12	8
	Posaconazole	0.25-1	0.5	1
	Amphotericin B	1-2	1	2
	Itraconazole	0.5-16	1	16
	Flucytosine	0.03-0.06	0.03	0.06
Rhodotorula mucila- ginosa (n=4)	Anidulafungin	8	8	8
	Caspofungin	4-8	8	8
	Micafungin	8	8	8
	Fluconazole	4-256	128	256
	Voriconazole	2-4	4	4
	Posaconazole	1-4	2	4
	Amphotericin B	1	1	1
	Itraconazole	1-4	2	4
	Flucytosine	0.06-0.12	0.12	0.12
Trichosporon japoni- cum(n=3)	Anidulafungin	8	8	8
	Caspofungin	4-8	8	8
	Micafungin	8	8	8
	Fluconazole	256	256	256
	Voriconazole	8	8	8
	Posaconazole	1-8	2	8
	Amphotericin b	0.5-2	1	2
	Itraconazole	0.5-16	16	16
	Flucytosine	32-64	64	64
Candida duobushae- mulonis(n=2)	Anidulafungin	0.015-0.03	0.015	0.03
	Caspofungin	0.06	0.06	0.06
	Micafungin	0.03-0.06	0.03	0.06
	Fluconazole	2	2	2
	Voriconazole	0.03	0.03	0.03
	Posaconazole	0.015-0.03	0.015	0.03
	Amphotericin B	2	2	2
	Itraconazole	0.06	0.06	0.06
	Flucytosine	0.03-0.06	0.03	0.06
Candida auris (n=2)	Anidulafungin	0.12-0.5	0.12	0.5
	Caspofungin	0.12-0.25	0.12	0.25
	Micafungin	0.25	0.25	0.25
	Fluconazole	32-128	32	128
	Voriconazole	0.25-1	0.25	1
	Posaconazole	0.12-0.25	0.12	0.25
	Amphotericin B	4	4	4
	Itraconazole	0.5	0.5	0.5
	Flucytosine	0.06	0.6	0.06
Candida rugosa (n=2)	Anidulafungin	0.06	0.06	0.06
	Caspofungin	0.06-0.12	0.06	0.12
	Micafungin	0.06-0.25	0.06	0.25
	Fluconazole	2-8	2	8
	Voriconazole	0.12-0.25	0.12	0.25
	Posaconazole	0.06-0.25	0.06	0.25
	Amphotericin B	0.5-1	0.5	1
	Itraconazole	0.12-0.5	0.12	0.5
	Flucytosine	0.12	0.12	0.12
Malassezia furfur (n=2)	Anidulafungin	0.06-0.25	0.06	0.25
	Caspofungin	0.06-0.25	0.06	0.25
	Micafungin	0.06-0.25	0.06	0.25
	Fluconazole	0.25-0.5	0.25	0.5
	Voriconazole	0.015	0.015	0.015
	Posaconazole	0.12	0.12	0.12
	Amphotericin B	1	1	1
	Itraconazole	0.25	0.25	0.25
	Flucytosine	0.06	0.06	0.06
Candida norvegensis (n=2)	Anidulafungin	0.06	0.06	0.06
	Caspofungin	0.12-0.5	0.12	0.5
	Micafungin	0.06-0.12	0.06	0.12
	Fluconazole	8-32	8	32
	Voriconazole	0.25-1	0.25	1
	Posaconazole	0.06-0.25	0.06	0.25
	Amphotericin B	0.5-2	0.5	2
	Itraconazole	0.25-0.5	0.25	0.5
	Flucytosine	4-16	4	16
Lodderomyces elongisporus (n=2)	Anidulafungin	0.015-0.03	0.015	0.03
	Caspofungin	0.12	0.12	0.12
	Micafungin	0.03-0.06	0.03	0.06
	Fluconazole	0.12-0.5	0.12	0.5
	Voriconazole	0.008	0.008	0.008
	Posaconazole	0.12	0.12	0.12
	Amphotericin B	0.5	0.5	0.5
	Itraconazole	0.12-0.25	0.12	0.25
	Flucytosine	0.12	0.12	0.12
Trichosporon mucoides (n=1)	Anidulafungin	8	/	/
	Caspofungin	8	/	/
	Micafungin	8	/	/
	Fluconazole	0.25	/	/
	Voriconazole	0.015	/	/
	Posaconazole	0.03	/	/
	Amphotericin B	0.5	/	/
	Itraconazole	0.06	/	/
	Flucytosine	16	/	/

Table 20

Table 21

Table 22

Table 23

Table 24

Table 25

Table 26

Table 27

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Specimen type		No. of specimens and constituent ratio (%)
Sterile site specimens
	Blood	763 (37.33)
	Pleural and peritoneal fluid	317 (15.51)
	Bile	142 (6.95)
	Tissue	28 (1.37)
	Aspiration Fluid	18 (0.88)
	Cerebrospinal fluid	22 (1.08)
	Amniotic fluid	6 (0.29)
	Placenta	1 (0.05)
	Bone marrow	1 (0.05)
	Synovial fluid	1 (0.05)
	Cyst fluid	1 (0.05)
Non-sterile site specimens
	Catheter	157 (7.68)
	Drainage fluid	156 (7.63)
	Wound secretions	131 (6.41)
	Broncho alveolar lavage fluid	91 (4.45)
	Purulent exudate	86 (4.21)
	Urine	35 (1.71)
	Sputum	15 (0.73)
	Ear secretions	8 (0.39)
	Uterine cavity secretions	5 (0.24)
	Eye secretions	4 (0.20)
	Unknown	56 (2.74)
Total		2044 (100)

Specimen type		No. of specimens and constituent ratio (%)
Sterile site specimens
	Blood	3 (0.97)
	Pleural fluid	1 (0.32)
	Bone marrow	1 (0.32)
Non-sterile site specimens
	Sputum	165 (53.23)
	Bronchoalveolar lavage fluid	97 (31.29)
	Corneal scrapings	12 (3.87)
	Wound secretions	3 (0.97)
	Purulent exudate	3 (0.97)
	Eye secretions	3 (0.97)
	Ear secretions	1 (0.32)
	Nail clippings	1 (0.32)
	Unknown	20 (6.45)
	Total	310 (100)

Species	No. of isolates and composition ratio (%)
Candida albicans	793 (38.80)
Candida tropicalis	389 (19.03)
Candida parapsilosis	342 (16.73)
Candida glabrata	313 (15.31)
Candida krusei	36 (1.76)
Cryptococcus neoformans	34 (1.66)
Trichosporon asahii	26 (1.27)
Candida lusitaniae	20 (0.98)
Candida metapsilosis	18 (0.88)
Candida guilliermondii	17 (0.83)
Candida orthopsilosis	15 (0.73)
Kodamaea ohmeri	9 (0.44)
Saccharomyces cerevisiae	8 (0.39)
Candida fermentati	4 (0.20)
Rhodotorula mucilaginosa	4 (0.20)
Trichosporon japonicum	3 (0.15)
candida duobushaemulonis	2 (0.10)
Candida auris	2 (0.10)
Candida rugosa	2 (0.10)
Malassezia furfur	2 (0.10)
Candida norvegensis	2 (0.10)
Lodderomyces elongisporus	2 (0.10)
Trichosporon mucoides	1 (0.05)

Species	No. of isolates and composition ratio	No. of isolates and composition ratio isolated from sterile site	No. of isolates and composition ratio isolated from non-sterile site
Aspergillus fumigatus	193（62.26）	5（100）	188（61.64）
Aspergillus flavus	82（26.45）	0（0）	82（26.89）
Aspergillus niger	18（5.81）	0（0）	18（5.90）
Aspergillus terreus	11（3.55）	0（0）	11（3.61）
Rhizopus microsporus	2（0.65）	0（0）	2（0.66）
Fusarium solani	2（0.65）	0（0）	2（0.66）
Aspergillus nidulans	1（0.32）	0（0）	1（0.33）
Aspergillus tamarii	1（0.32）	0（0）	1（0.33）

Fungal resistance surveillance report in East China in 2025

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Antifungal agents	MIC range (µg/mL)	MIC₅₀ (µg/mL)	MIC₉₀ (µg/mL)	Susceptibility distribution (%)
Antifungal agents	MIC range (µg/mL)	MIC₅₀ (µg/mL)	MIC₉₀ (µg/mL)	S	SDD	I	R	WT	NWT
Anidulafungin	0.015-0.25	0.03	0.06	100	/	0	0	/	/
Caspofungin	0.015-0.25	0.06	0.12	100	/	0	0	/	/
Micafungin	0.015-0.5	0.015	0.06	99.59	/	0.41	0	/	/
Fluconazole	0.12-256	0.5	2	91.74	3.26	/	5	/	/
Voriconazole	0.008-8	0.015	0.12	92.56	/	3.72	3.72	/	/
Posaconazole	0.015-2	0.06	0.06	/	/	/	/	92.56	7.44
Amphotericin B	0.25-1	0.5	1	/	/	/	/	100	0
Itraconazole	0.015-0.25	0.12	0.25	/	/	/	/	/	/
Flucytosine	0.06-64	0.06	0.12	/	/	/	/	/	/

Antifungal agents	MIC range (µg/mL)	MIC₅₀(µg/mL)	MIC₉₀ (µg/mL)	Susceptibility distribution (%)
Antifungal agents	MIC range (µg/mL)	MIC₅₀(µg/mL)	MIC₉₀ (µg/mL)	WT	NWT
Anidulafungin	8	8	8	/	/
Caspofungin	4-8	8	8	/	/
Micafungin	8	8	8	/	/
Fluconazole	0.5-256	8	8	88.24	11.76
Voriconazole	0.03-0.25	0.12	0.12	100	0
Posaconazole	0.03-0.25	0.12	0.25	100	0
Amphotericin B	0.125-1	0.5	1	92.05	7.95
Itraconazole	0.03-2	0.12	0.25	79.41	20.59
Flucytosine	1-256	4	8	94.12	5.88

Antifungal agents	MIC/MEC range (µg/mL)	MIC₅₀/MEC₅₀ (µg/mL)	MIC₉₀/MEC₉₀ (µg/mL)	Susceptibility distribution (%)
Antifungal agents	MIC/MEC range (µg/mL)	MIC₅₀/MEC₅₀ (µg/mL)	MIC₉₀/MEC₉₀ (µg/mL)	S	SDD	I	R	WT	NWT
Anidulafungin	0.015-0.03	0.015	0.015	/	/	/	/	/	/
Caspofungin	0.06-0.25	0.12	0.12	/	/	/	/	100	/
Micafungin	0.008-0.03	0.015	0.015	/	/	/	/	/	/
Voriconazole	0.12-8	0.5	0.5	/	/	3.63	5.18	/	/
Posaconazole	0.06-2	0.25	0.25	/	/	/	/	/	/
Amphotericin B	0.5-2	1	2	/	/	/	/	100	0
Itraconazole	0.12-16	0.5	0.5	/	/	/	/	96.89	3.11
Isavuconazole	0.12-8	0.5	1	96.45	/	0.65	2.90	/	/

Geographical origin	MIC/MEC (μg/mL)								Specimen type
Geographical origin	Anidulafungin	Caspofungin	Micafungin	Amphotericin B	Isavuconazole	Itraconazole	Posaconazole	Voriconazole	Specimen type
Jiangsu	0.015	0.25	0.015	1	4	2	1	2	Sputum
Jiangsu	0.015	0.12	0.015	1	4	2	1	4	Sputum
Jiangsu	0.03	0.12	0.015	1	4	16	1	4	Sputum
Jiangsu	0.015	0.12	0.015	1	8	16	1	4	Balf
Jiangsu	0.015	0.12	0.015	1	2	1	1	2	Sputum
Jiangsu	0.015	0.06	0.008	1	8	0.5	1	8	BALF
Jiangsu	0.015	0.06	0.008	1	2	0.5	0.5	1	Sputum
Jiangsu	0.015	0.06	0.008	1	8	1	1	8	Sputum
Jiangsu	0.015	0.12	0.015	1	8	16	1	8	Sputum
Fujian	0.015	0.06	0.008	0.5	4	0.5	0.25	2	Ocular discharge
Fujian	0.015	0.06	0.008	2	8	2	2	8	Sputum

Antifungal agents	MIC/MEC range (µg/mL)	MIC₅₀ /MEC₅₀ (µg/mL)	MIC₉₀/MEC₉₀ (µg/mL)	Susceptibility distribution (%)
Antifungal agents	MIC/MEC range (µg/mL)	MIC₅₀ /MEC₅₀ (µg/mL)	MIC₉₀/MEC₉₀ (µg/mL)	S	SDD	I	R	WT	NWT
Anidulafungin	0.015-0.03	0.015	0.015	/	/	/	/	/	/
Caspofungin	0.06-0.25	0.12	0.12	/	/	/	/	100	0
Micafungin	0.008-0.03	0.015	0.015	/	/	/	/	/	/
Voriconazole	0.5-2	1	1	/	/	/	/	100	0
Posaconazole	0.12-1	0.5	0.5	/	/	/	/	100	0
Amphotericin B	1-4	2	4	/	/	/	/	100	0
Itraconazole	0.25-0.5	0.5	0.5	/	/	/	/	100	0
Isavuconazole	0.5-1	1	1	/	/	/	/	100	0

Antifungal agents	MIC/MEC range (µg/mL)	MIC₅₀ /MEC₅₀(µg/mL)	MIC₉₀/MEC₉₀(µg/mL)	Susceptibility distribution (%)
Antifungal agents	MIC/MEC range (µg/mL)	MIC₅₀ /MEC₅₀(µg/mL)	MIC₉₀/MEC₉₀(µg/mL)	S	SDD	I	R	WT	NWT
Anidulafungin	0.015-0.12	0.015	0.03	/	/	/	/	/	/
Caspofungin	0.06-0.12	0.06	0.12	/	/	/	/	100	0
Micafungin	0.008-0.015	0.008	0.015	/	/	/	/	/	/
Voriconazole	0.25-1	0.5	1	/	/	/	/	83.33	16.67
Posaconazole	0.03-2	0.5	2	/	/	/	/	100	0
Amphotericin B	0.5-2	1	2	/	/	/	/	100	0
Itraconazole	0.12-16	1	16	/	/	/	/	83.33	16.67
Isavuconazole	0.12-8	2	8	/	/	/	/	83.33	16.67

Geographical origin	MIC/MEC (μg/mL)								Specimen type
Geographical origin	Anidulafungin	Caspofungin	Micafungin	Amphotericin B	Isavuconazole	Itraconazole	Posaconazole	Voriconazole	Specimen type
Jiangsu	0.015	0.12	0.015	0.5	8	16	2	8	Sputum
Fujian	0.015	0.06	0.008	1	8	16	1	8	Sputum
Fujian	0.015	0.06	0.008	1	8	16	2	8	Sputum

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