Journal of Diagnostics Concepts & Practice >

2026 , Vol. 25 >Issue 03: 287 - 307

DOI: https://doi.org/10.16150/j.1671-2870.2026.03.005

Original articles

Fungal resistance surveillance report in East China in 2025

  • 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
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  • 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 date: 2026-03-02

  Revised date: 2026-05-13

  Accepted date: 2026-05-18

  Online published: 2026-06-27

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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

Cite this article

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 . DOI: 10.16150/j.1671-2870.2026.03.005

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