Related Experiment Video
Updated: Aug 31, 2025
Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
Published on: December 28, 2017
Global Prevalence of Antifungal-Resistant Candida parapsilosis: A Systematic Review and Meta-Analysis
Dina Yamin1, Mutiat Hammed Akanmu2, Abbas Al Mutair3,4,5,6
1Department of Medical Microbiology & Parasitology, School of Medical Sciences, Universiti Sains Malaysia, George Town 16150, Malaysia.
Abstract:
A reliable estimate of Candida parapsilosis antifungal susceptibility in candidemia patients is increasingly important to track the spread of C. parapsilosis bloodstream infections and define the true burden of the ongoing antifungal resistance. A systematic review and meta-analysis (SRMA) were conducted aiming to estimate the global prevalence and identify patterns of antifungal resistance. A systematic literature search of the PubMed, Scopus, ScienceDirect and Google Scholar electronic databases was conducted on published studies that employed antifungal susceptibility testing (AFST) on clinical C. parapsilosis isolates globally. Seventy-nine eligible studies were included. Using meta-analysis of proportions, the overall pooled prevalence of three most important antifungal drugs; Fluconazole, Amphotericin B and Voriconazole resistant C. parapsilosis were calculated as 15.2% (95% CI: 9.2-21.2), 1.3% (95% CI: 0.0-2.9) and 4.7% (95% CI: 2.2-7.3), respectively. Based on study enrolment time, country/continent and AFST method, subgroup analyses were conducted for the three studied antifungals to determine sources of heterogeneity. Timeline and regional differences in C. parapsilosis prevalence of antifungal resistance were identified with the same patterns among the three antifungal drugs. These findings highlight the need to conduct further studies to assess and monitor the growing burden of antifungal resistance, to revise treatment guidelines and to implement regional surveillance to prevent further increase in C. parapsilosis drug resistance emerging recently.
Insights
Antifungal resistance in Candida parapsilosis bloodstream infections is a growing concern. This review found 15.2% of Candida parapsilosis strains resistant to fluconazole globally, highlighting the need for monitoring and revised treatment guidelines.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Candida parapsilosis bloodstream infections (candidemia) pose a significant global health challenge.
- Tracking antifungal resistance in C. parapsilosis is crucial for effective treatment and public health surveillance.
Purpose of the Study:
- To estimate the global prevalence of antifungal resistance in Candida parapsilosis.
- To identify temporal and regional patterns of antifungal resistance in C. parapsilosis.
Main Methods:
- A systematic review and meta-analysis (SRMA) of published studies.
- Inclusion of 79 studies employing antifungal susceptibility testing (AFST) on clinical C. parapsilosis isolates worldwide.
- Meta-analysis of proportions to calculate pooled prevalence rates for key antifungal drugs.
Main Results:
- The overall pooled prevalence of resistance was 15.2% for fluconazole, 1.3% for amphotericin B, and 4.7% for voriconazole.
- Subgroup analyses revealed significant timeline and regional variations in resistance patterns.
- Identified consistent resistance trends across the three major antifungal agents.
Conclusions:
- Antifungal resistance in C. parapsilosis is a growing global issue requiring continuous monitoring.
- Findings underscore the necessity for updated treatment guidelines and regional surveillance strategies.
- Further research is essential to combat the emerging drug resistance in C. parapsilosis infections.
