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Volume 31, Number 7—July 2025

Research

Emergence of Flucytosine-Resistant Candida tropicalis Clade, the Netherlands

Fatima Zohra Delma1, Bram Spruijtenburg1, Jacques F. Meis, Auke W. de Jong, James Groot, Johanna Rhodes, Willem J.G. Melchers, Paul E. Verweij, Theun de Groot, Eelco F.J. Meijer2, and Jochem B. Buil2Comments to Author 
Author affiliation: Radboud University Medical Center, Nijmegen, the Netherlands (F.Z. Delma, B. Spruijtenburg, J.F. Meis, J. Rhodes, W.J.G. Melchers, P.E. Verweij, T. de Groot, E.F.J. Meijer, J.B. Buil); Canisius-Wilhelmina Hospital (CWZ)/Dicoon, Nijmegen (B. Spruijtenburg, T. de Groot, E.F.J. Meijer); University of Cologne, Cologne, Germany (J.F. Meis); National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands (A.W. de Jong, J. Groot, P.E. Verweij)

Main Article

Figure 5

Trends in percentages of flucytosine-resistant and fluconazole-resistant non–wild-type (WT) Candida tropicalis isolates, the Netherlands, 2012–2022. A) Percentages of flucytosine (5-FC) non-WT isolates within the specific clade identified in the Netherlands. B) Percentages of all 5-FC non-WT isolates, regardless of clade affiliation. Isolates with a 5-FC MIC above the local epidemiologic cutoff of 0.5 mg/L were classified as non-WT. C) Percentage of fluconazole non-WT isolates. Isolates with a MIC above the local epidemiologic cutoff of 1 mg/L were classified as non-WT. D) Percentage of fluconazole-resistant non-WT isolates. Isolates with values above the EUCAST clinical breakpoint of 4 mg/L were classified as resistant. Solid vertical lines indicate slopes; dotted lines above and below the slope indicate 95% CIs. Error bars indicate SEM. Slopes significantly deviated from zero in panels A and B (p<0.001 for both) but not in panels C (p = 0.992) or D (p = 0.640).

Figure 5. Trends in percentages of flucytosine-resistant and fluconazole-resistant non–wild-type (WT) Candida tropicalis isolates, the Netherlands, 2012–2022. A) Percentages of flucytosine (5-FC) non-WT isolates within the specific clade identified in the Netherlands. B) Percentages of all 5-FC non-WT isolates, regardless of clade affiliation. Isolates with a 5-FC MIC above the local epidemiologic cutoff of 0.5 mg/L were classified as non-WT. C) Percentage of fluconazole non-WT isolates. Isolates with a MIC above the local epidemiologic cutoff of 1 mg/L were classified as non-WT. D) Percentage of fluconazole-resistant non-WT isolates. Isolates with values above the EUCAST clinical breakpoint of 4 mg/L were classified as resistant. Solid vertical lines indicate slopes; dotted lines above and below the slope indicate 95% CIs. Error bars indicate SEM. Slopes significantly deviated from zero in panels A and B (p<0.001 for both) but not in panels C (p = 0.992) or D (p = 0.640).

Main Article

1These first authors contributed equally to this article.

2These senior authors contributed equally to this article.

Page created: May 15, 2025
Page updated: June 25, 2025
Page reviewed: June 25, 2025
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