{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T13:45:09Z","timestamp":1791726309187,"version":"4.3.4"},"reference-count":42,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100017950","name":"Shanghai Municipal Health Commission","doi-asserted-by":"publisher","award":["202340223"],"award-info":[{"award-number":["202340223"]}],"id":[{"id":"10.13039\/100017950","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007219","name":"Natural Science Foundation of Shanghai Municipality","doi-asserted-by":"publisher","award":["23ZR1408100"],"award-info":[{"award-number":["23ZR1408100"]}],"id":[{"id":"10.13039\/100007219","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,5,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Vulvovaginal candidiasis (VVC) represents a global health issue. However, epidemiological data on VVC in eastern China are scarce, limited, and outdated. To address this gap, we conducted a six-year retrospective study (2019\u20132024), investigating the epidemiological characteristics, species distribution, and antifungal susceptibility patterns of VVC patients in Shanghai, China. VVC was confirmed based on clinical symptoms combined with laboratory examination.\n                      <jats:italic toggle=\"yes\">Candida<\/jats:italic>\n                      species were identified by MALDI-TOF MS, and\n                      <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                      antifungal susceptibility testing (AFST) was carried out using the ATB FUNGUS 3 method. The epidemiological changes over time were analyzed using the\n                      <jats:italic toggle=\"yes\">\u03c7<\/jats:italic>\n                      2 test for trend. In total, 7,894 VVC episodes were identified among 7,167 individuals. Of these, 39 patients (0.54%) exhibited mixed\n                      <jats:italic toggle=\"yes\">Candida<\/jats:italic>\n                      infections.\n                      <jats:italic toggle=\"yes\">Candida albicans<\/jats:italic>\n                      was the predominant species (77.26%), followed by\n                      <jats:italic toggle=\"yes\">Candida glabrata<\/jats:italic>\n                      (17.63%),\n                      <jats:italic toggle=\"yes\">Candida parapsilosis<\/jats:italic>\n                      (1.53%),\n                      <jats:italic toggle=\"yes\">Candida tropicalis<\/jats:italic>\n                      (1.17%), and\n                      <jats:italic toggle=\"yes\">Candida krusei<\/jats:italic>\n                      (1.00%). Other species were rare, each accounting for less than 1.0%. VVC shows high prevalence in our region, with\n                      <jats:italic toggle=\"yes\">C. albicans<\/jats:italic>\n                      as the most prevalent pathogen, followed by\n                      <jats:italic toggle=\"yes\">C. glabrata<\/jats:italic>\n                      . And an increasing trend in\n                      <jats:italic toggle=\"yes\">C. glabrata<\/jats:italic>\n                      VVC was observed, accompanied by consistently high rates of voriconazole resistance. Fluconazole resistance was observed in 18.82% of\n                      <jats:italic toggle=\"yes\">C. albicans<\/jats:italic>\n                      with cross-resistance to other azoles. Thus, our findings highlight the significance of\n                      <jats:italic toggle=\"yes\">Candida<\/jats:italic>\n                      species identification and accurate diagnosis in VVC, underscoring the necessity for targeted antifungal management.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>\n                      Vulvovaginal candidiasis is a widespread condition among women, associated with significant emotional, physical, and economic burdens, and presents ongoing challenges in diagnosis and management. Our six-year Shanghai study reveals\n                      <jats:italic toggle=\"yes\">Candida<\/jats:italic>\n                      species caused 9.66% of vaginitis cases, with\n                      <jats:italic toggle=\"yes\">C. albicans<\/jats:italic>\n                      remaining predominant and showing alarming fluconazole resistance (18.82%). Particularly concerning is the rising trend of non-albicans\n                      <jats:italic toggle=\"yes\">Candida<\/jats:italic>\n                      , especially\n                      <jats:italic toggle=\"yes\">C. glabrata<\/jats:italic>\n                      . These findings critically emphasize the necessity of implementing routine species identification and continuous antifungal susceptibility testing in China to guide targeted therapy, curb resistance spread, and optimize VVC management strategies.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.03251-25","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T13:02:36Z","timestamp":1775566956000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":2,"title":["Epidemiology of vulvovaginal candidiasis in China: a six-year retrospective single-center study from a tertiary obstetrics and gynecology hospital in 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