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Volume 31, Number 10—October 2025

CME ACTIVITY - Research

Recent Systemic Antifungal Exposure and Nonsusceptible Candida in Hospitalized Patients, South Africa, 2012–2017

Charlotte Rabault, Liliwe Shuping, Ruth Mpembe, Vanessa Quan, Fanny Lanternier, Olivier Lortholary, Olivier Paccoud, Nelesh P. GovenderComments to Author , and for GERMS-SA
Author affiliation: National Institute for Communicable Diseases, Johannesburg, South Africa (C. Rabault, L. Shuping, R. Mpembe, V. Quan, N.P. Govender); Hôpital Universitaire Necker-Enfants malades Service des Maladies Infectieuses et Tropicales Adultes, Paris, France (C. Rabault, F. Lanternier, O. Lortholary, O. Paccoud); Institut Pasteur, Paris (F. Lanternier, O. Lortholary); Université Paris Cité, Paris (F. Lanternier, O. Lortholary ,O. Paccoud); University of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg (N.P. Govender); University of Cape Town Faculty of Health Sciences, Western Cape, South Africa (N.P. Govender); University of Exeter MRC Centre for Medical Mycology, Exeter, UK (N.P. Govender)

Main Article

Table 3

Comparaison of distribution of Candida isolates in patients >90 d of age (n = 1,301) with and without prior antifungal exposure, South Africa, 2012–2017*

Isolate
 No prior exposure, 
n = 1,101
 Prior exposure
To azoles, n = 151
 p value
To echinocandins, n = 41
 p value
To amphotericin B, n = 28
 p value
C. albicans 518 (47) 42 (28) <0.001 4 (10) <0.001 6 (21) ND
Nakaseomyces glabratus 202 (18) 20 (13) 0.09 1 (2) ND/ 1 (3) ND
C. auris
 44 (4)
 16 (10)
 <0.001
10 (24)
 ND
9 (32)
 ND
C. parapsilosis 245 (22) 54 (36) <0.001 24 (59) <0.001 8 (29) ND
FLU-R 121 (11) 32 (21) 0.19 22 (54) <0.001 2 (7) ND
FLU-S
 124 (11)
 22 (15)
 ND
2 (5)
 ND
6 (21)
 ND
C. tropicalis 57 (5) 8 (5) 0.97 2 (5) ND 2 (7) ND
Pichia kudriavzevii 34 (3) 11 (7) 0.005 0 (0) ND 2 (7) ND

*Values are no. (%) except as indicated. Cases with multiple exposures or mixed episodes are excluded. p values derived by Fisher exact test when validation conditions were met. FLU-R, fluconazole nonsusceptible; FLU-S, fluconazole susceptible; ND, not determined because of the lack of verification of the assumptions required for the statistical tests.

Main Article

Page created: August 04, 2025
Page updated: September 24, 2025
Page reviewed: September 24, 2025
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