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[阿根廷布宜诺斯艾利斯市医院的真菌血症]

[Fungemia in hospitals of the city of Buenos Aires, Argentina].

作者信息

López Moral Laura, Tiraboschi Iris Nora, Schijman Mariela, Bianchi Mario, Guelfand Liliana, Cataldi Silvana

机构信息

Sección Microbiología, Laboratorio Central, Hospital General de Agudos Dr. C. Argerich, Buenos Aires, Argentina.

出版信息

Rev Iberoam Micol. 2012 Jul-Sep;29(3):144-9. doi: 10.1016/j.riam.2011.11.001. Epub 2011 Nov 25.

Abstract

BACKGROUND

The incidence of fungi like pathogens in hospitals varies by regions.

OBJECTIVES

Our goal was not only to record the incidence and etiology of fungaemia, but also the change during the 4 years analysed, to determine the time of detection in automated blood culture and by lysis-centrifugation, and finally to assess the gender, age and underlying disease of the patients with fungaemia.

METHODS

An observational multicentre study of fungaemia was conducted in hospitals in the Mycology Network of Buenos Aires.

RESULTS

A total of 190,920 blood cultures were processed: 182,050 automated blood culture and 8,870 lysis-centrifugation. Fungi were recovered in 1,020 episodes. The overall incidence of fungaemia was 1.72/1,000 admissions; 683 episodes were due to Candida (68%), and 325 (32%) to other fungi: 214 Cryptococcus, 105 Histoplasma, 7 Rhodotorula, 5 Trichosporon, 2 Pichia, 2 Acremonium, one Saccharomyces and one Fusarium. The incidence of candidaemia was 1.15/1,000 admissions with a wide variation between centres (0.35 to 2.65). Most Candida isolates (97%) were detected in the first 2 days of incubation. Candida albicans was recovered in 43% of the episodes. In fungaemia other than candidaemia, the predominant fungi were Cryptococcus and Histoplasma capsulatum.

CONCLUSIONS

The incidence remained stable during the study period. Fungaemia by Candida were predominant. C. albicans was involved in less than a half of the episodes. The recovery of Cryptoccocus and H. capsulatum is strongly associated with HIV patients.

摘要

背景

医院中真菌样病原体的发病率因地区而异。

目的

我们的目标不仅是记录真菌血症的发病率和病因,还要记录分析的4年期间的变化,确定自动血培养和裂解离心法的检测时间,最后评估真菌血症患者的性别、年龄和基础疾病。

方法

在布宜诺斯艾利斯真菌学网络的医院中进行了一项关于真菌血症的观察性多中心研究。

结果

共处理了190,920份血培养:182,050份自动血培养和8,870份裂解离心法血培养。在1,020例中分离出真菌。真菌血症的总体发病率为1.72/1000例入院;683例由念珠菌引起(68%),325例(32%)由其他真菌引起:214例隐球菌、105例荚膜组织胞浆菌、7例红酵母、5例毛孢子菌、2例毕赤酵母、2例枝顶孢、1例酿酒酵母和1例镰刀菌。念珠菌血症的发病率为1.15/1000例入院,各中心之间差异很大(0.35至2.65)。大多数念珠菌分离株(97%)在培养的前2天被检测到。白色念珠菌在43%的病例中被分离出。在非念珠菌血症的真菌血症中,主要真菌是隐球菌和荚膜组织胞浆菌。

结论

在研究期间发病率保持稳定。念珠菌引起的真菌血症占主导。白色念珠菌参与的病例不到一半。隐球菌和荚膜组织胞浆菌的检出与艾滋病患者密切相关。

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