{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:50:46Z","timestamp":1753883446842,"version":"3.41.2"},"reference-count":32,"publisher":"American Society for Microbiology","issue":"1","license":[{"start":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:00:00Z","timestamp":1704931200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T00:00:00Z","timestamp":1704931200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences","award":["2021-I2M-1-038"],"award-info":[{"award-number":["2021-I2M-1-038"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82202592"],"award-info":[{"award-number":["82202592"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National high level hospital clinical research funding","award":["2022-PUMCH-C-052"],"award-info":[{"award-number":["2022-PUMCH-C-052"]}]},{"name":"\u5317\u4eac\u5e02\u79d1\u5b66\u6280\u672f\u59d4\u5458\u4f1a | Natural Science Foundation of Beijing Municipality","award":["7222125"],"award-info":[{"award-number":["7222125"]}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2024,1,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            The antifungal susceptibility profile and epidemiological cut-off values (ECOFFs) of\n            <jats:italic>Yarrowia lipolytica<\/jats:italic>\n            , a rare opportunistic yeast, remain unclear. We conducted a comprehensive multi-method study on clinical isolates from various central hospitals, based on the China Hospital Invasive Fungal Surveillance Network (2009\u20132022). Our objective was to evaluate the antifungal susceptibility of\n            <jats:italic>Y. lipolytica<\/jats:italic>\n            , establish its local ECOFFs (L-ECOFFs), and compare the performance of the ATB FUNGUS 3 (ATB), Sensititre YeastOne (SYO), and minimum inhibitory concentration (MIC) test strip (MTS) with that of the broth microdilution (BMD) method. L-ECOFFs were established using ECOFFinder, and we examined\n            <jats:italic>ERG11<\/jats:italic>\n            mutations to assess the reliability of the L-ECOFFs. The L-ECOFF for fluconazole was 8 \u00b5g\/mL. Non-wild-type isolates of antifungal drugs, such as flucytosine and azoles, were exclusively isolated from patients. Additionally, we detected that four strains with the\n            <jats:italic>ERG11<\/jats:italic>\n            A395T mutation (azole MIC &gt;L-ECOFF) may be associated with the exposure to azole drugs. For azoles, ATB showed the highest essential agreement with the BMD (98.18%\u2013100%), followed by SYO (85.45%\u2013100%). However, ATB could not detect susceptibility to echinocandins, while SYO exhibited the highest agreement (98.18%\u2013100%) in detecting echinocandin susceptibility. Our findings indicate that acquired azole cross-resistance has emerged despite\n            <jats:italic>Y. lipolytica<\/jats:italic>\n            infections being rare. This research provides crucial antifungal susceptibility data and establishes the initial L-ECOFFs for\n            <jats:italic>Y. lipolytica<\/jats:italic>\n            . The SYO is recommended as the optimal laboratory antifungal susceptibility testing method for\n            <jats:italic>Y. lipolytica<\/jats:italic>\n            , followed by ATB, whereas the use of MTS requires caution. We hope that this study will facilitate improved clinical management of\n            <jats:italic>Y. lipolytica<\/jats:italic>\n            infections.\n          <\/jats:p>\n          <jats:sec>\n            <jats:title>IMPORTANCE<\/jats:title>\n            <jats:p>\n              <jats:italic>Yarrowia lipolytica<\/jats:italic>\n              , also known as\n              <jats:italic>Candida lipolytica<\/jats:italic>\n              , is an emerging opportunistic \u201crare pathogenic yeast\u201d. Due to the limited data on its antifungal susceptibility, the clinical treatments become challenging. Based on the China Hospital Invasive Fungal Surveillance Network (2009\u20132022), we conducted a comprehensive multi-method study on clinical isolates from various central hospitals. This study is currently the largest study carried out to assess the antifungal susceptibility of\n              <jats:italic>Y. lipolytica<\/jats:italic>\n              . It is also the first to establish local epidemiological cut-off values (L-ECOFFs), identify its\n              <jats:italic>ERG11<\/jats:italic>\n              mutations, and assess the consistency between the three prevalent commercial antifungal susceptibility testing methods and the broth microdilution method. We recommend the Sensititre YeastOne as the best option for antifungal susceptibility testing for\n              <jats:italic>Y. lipolytica<\/jats:italic>\n              , followed by the ATB FUNGUS 3. Nevertheless, practitioners should use the MIC test strip with discretion.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/spectrum.03203-23","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T14:01:36Z","timestamp":1702389696000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":5,"title":["Antifungal susceptibility profile and local epidemiological cut-off values of\n            <i>Yarrowia<\/i>\n            (\n            <i>Candida<\/i>\n            )\n            <i>lipolytica<\/i>\n            : an emergent and rare opportunistic yeast"],"prefix":"10.1128","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3807-2088","authenticated-orcid":false,"given":"Jinhan","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences , Beijing, China"},{"name":"Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases , Beijing, China"},{"name":"Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences , Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xueqing","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Yongzhou Central Hospital , Yongzhou, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawen","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Microbiology, the First Affiliated Hospital, Harbin Medical University , Harbin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenhang","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences , Beijing, China"},{"name":"Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases , Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xinfei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences , Beijing, China"},{"name":"Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases , Beijing, China"},{"name":"Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences , Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guiling","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Microbiology, the Fourth Affiliated Hospital, Harbin Medical University , Harbin, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences , Beijing, China"},{"name":"Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases , Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shichao","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The Second Affiliated Hospital of Luohe Medical College , Luohe, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ge","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, State Key Laboratory 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