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We conducted a 40-year surveillance study analyzing the antifungal susceptibility of 131 T. marneffei isolates collected from the clinical laboratory of the First Affiliated Hospital of Guangxi Medical University between 1984 and 2024. In vitro susceptibilities to conventional antifungal agents, including itraconazole, voriconazole, fluconazole, and amphotericin B, were analyzed using the Clinical and Laboratory Standards Institute broth microdilution method. We also explored the potential influence of host Human Immunodeficiency Virus (HIV) status and fungal mating type (MAT) on susceptibility patterns. The minimum inhibitory concentrations (MICs) for itraconazole, voriconazole, fluconazole, and amphotericin B ranged from 0.015 to 0.06\u00a0\u03bcg\/ml, 0.008 to 0.03\u00a0\u03bcg\/ml, 1 to 8\u00a0\u03bcg\/ml, and 0.25 to 1\u00a0\u03bcg\/ml, respectively. Fluconazole showed a significant decline in susceptibility over time (P\u00a0&amp;lt;\u00a0.01), whereas the susceptibilities to the other antifungals remained stable (P\u00a0&amp;gt;\u00a0.05). The correlations observed between the MICs of different triazoles (P\u00a0&amp;lt;\u00a0.01) suggest potential cross-resistance among triazoles. MAT and HIV infection status did not significantly affect antifungal susceptibility patterns (P\u00a0&amp;gt;\u00a0.05). These findings underscore the importance of ongoing antifungal susceptibility surveillance in T. marneffei, considering the changes in fluconazole susceptibility and potential triazole cross-resistance, while other antifungals remain stable.<\/jats:p>","DOI":"10.1093\/mmy\/myaf047","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T07:46:28Z","timestamp":1748591188000},"source":"Crossref","is-referenced-by-count":8,"title":["A 40-year antifungal susceptibility surveillance of\n                    <i>Talaromyces marneffei<\/i>\n                    (1984\u20132024) at a tertiary hospital in Guangxi, China"],"prefix":"10.1093","volume":"63","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3932-4542","authenticated-orcid":false,"given":"Xinyu","family":"Zhou","sequence":"first","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University Department of Dermatology and Venereology, , Nanning, Guangxi 530021 ,","place":["China"]},{"name":"Guangxi Scientific and Technological Innovation Cooperation Base of Mycosis Prevention and Control , Nanning, Guangxi 530021 ,","place":["China"]},{"name":"Guangxi Key Laboratory of AIDS Prevention and Treatment, Guangxi Medical University , Nanning, Guangxi 530021 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanqing","family":"Zheng","sequence":"additional","affiliation":[{"name":"Fourth People's Hospital of Nanning , Nanning, Guangxi 530023 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongyan","family":"Zheng","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University Department of Dermatology and Venereology, , Nanning, Guangxi 530021 ,","place":["China"]},{"name":"Guangxi Scientific and Technological Innovation Cooperation Base of Mycosis Prevention and Control , Nanning, Guangxi 530021 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Nanning, Guangxi 530021 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoqun","family":"Liu","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University Department of Dermatology and Venereology, , Nanning, Guangxi 530021 ,","place":["China"]},{"name":"Guangxi Scientific and Technological Innovation Cooperation Base of Mycosis Prevention and Control , Nanning, Guangxi 530021 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saroj","family":"Karki","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University Department of Dermatology and Venereology, , Nanning, Guangxi 530021 ,","place":["China"]},{"name":"Guangxi Scientific and Technological Innovation Cooperation Base of Mycosis Prevention and Control , Nanning, Guangxi 530021 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojuan","family":"He","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University Department of Dermatology and Venereology, , Nanning, Guangxi 530021 ,","place":["China"]},{"name":"Guangxi Scientific and Technological Innovation Cooperation Base of Mycosis Prevention and Control , Nanning, Guangxi 530021 ,","place":["China"]},{"name":"Guangxi Key Laboratory of AIDS Prevention and Treatment, Guangxi Medical University , Nanning, Guangxi 530021 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6279-0322","authenticated-orcid":false,"given":"Cunwei","family":"Cao","sequence":"additional","affiliation":[{"name":"The First Affiliated Hospital of Guangxi Medical University Department of Dermatology and Venereology, , Nanning, Guangxi 530021 ,","place":["China"]},{"name":"Guangxi Scientific and 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