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导尿管相关念珠菌尿症:危险因素、医学干预措施及抗真菌药敏性

Catheter-associated candiduria: Risk factors, medical interventions, and antifungal susceptibility.

作者信息

Padawer Dan, Pastukh Nina, Nitzan Orna, Labay Kozitta, Aharon Ilana, Brodsky Diana, Glyatman Tatyana, Peretz Avi

机构信息

Faculty of Medicine in the Galilee, Bar Ilan University, Safed, Israel.

Clinical Microbiology Laboratory, Baruch Padeh Medical Center, Poriya, Affiliated with the Faculty of Medicine in the Galilee, Bar Ilan University, Israel.

出版信息

Am J Infect Control. 2015 Jul 1;43(7):e19-22. doi: 10.1016/j.ajic.2015.03.013. Epub 2015 Apr 24.

Abstract

BACKGROUND

Catheter-associated candiduria is a common clinical finding in hospitalized patients, especially in the intensive care unit. The objective of this study was to obtain demographic and clinical data regarding the prevalence of Candida spp in catheterized in-patients and the medical interventions provided to these patients in a northern Israeli hospital between 2011 and 2013.

METHODS

Isolation and identification of microorganisms were performed on 1,408 urine culture samples 48 hours after catheter insertion. Antifungal Etest susceptibility tests were carried out on every Candida-positive urine sample. Demographic and clinical data were gathered to determine risk factors and medical interventions.

RESULTS

Candiduria was detected in 146 catheterized in-patients out of the 1,408 patients included in this study. C albicans was detected in most cases (69.1%). Fever was observed in 52 (35.61%) patients, and leukocyturia was observed in 48 cases (32.87%). Diabetes mellitus was associated with C albicans candiduria. There were 93 patients (63.69%) who did not receive any medical intervention for their candiduria.

CONCLUSION

Candida is the second leading pathogen causing catheter-associated urinary tract infection or asymptomatic colonization, whereas previous studies showed Candida as the third leading pathogen. Clinical signs and symptoms, such as fever and laboratory tests, cannot distinguish between asymptomatic colonization and infection. Because the management of catheter-associated candiduria is still controversial, additional studies should be carried out.

摘要

背景

导管相关性念珠菌尿是住院患者常见的临床现象,在重症监护病房尤为常见。本研究的目的是获取2011年至2013年期间以色列北部一家医院导尿住院患者中念珠菌属患病率的人口统计学和临床数据,以及针对这些患者的医疗干预措施。

方法

在导尿后48小时对1408份尿培养样本进行微生物分离和鉴定。对每份念珠菌阳性尿样进行抗真菌Etest药敏试验。收集人口统计学和临床数据以确定危险因素和医疗干预措施。

结果

本研究纳入的1408例导尿住院患者中,有146例检测到念珠菌尿。大多数病例(69.1%)检测到白色念珠菌。52例(35.61%)患者出现发热,48例(32.87%)患者出现白细胞尿。糖尿病与白色念珠菌性念珠菌尿有关。93例(63.69%)患者的念珠菌尿未接受任何医疗干预。

结论

念珠菌是引起导管相关性尿路感染或无症状定植的第二大主要病原体,而先前的研究显示念珠菌是第三大主要病原体。发热等临床体征和症状以及实验室检查无法区分无症状定植和感染。由于导管相关性念珠菌尿的管理仍存在争议,应开展更多研究。

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