Alothman Adel F, Althaqafi Abdulhakeem O, Matar Madonna J, Moghnieh Rima, Alenazi Thamer H, Farahat Fayssal M, Corman Shelby, Solem Caitlyn T, Raghubir Nirvana, Macahilig Cynthia, Charbonneau Claudie, Stephens Jennifer M
College of Medicine, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
Department of Infection Prevention and Control, King Abdullah International Medical Research Center, King Saud bin AbdulAziz University for Health Sciences, King AbdulAziz Medical City, Jeddah, Saudi Arabia.
Infect Drug Resist. 2017 Feb 2;10:35-41. doi: 10.2147/IDR.S97413. eCollection 2017.
The objective of this study was to document the burden and treatment patterns associated with invasive fungal infections (IFIs) due to and species in Saudi Arabia and Lebanon.
A retrospective chart review study was conducted using data recorded from 2011 to 2012 from hospitals in Saudi Arabia and Lebanon. Patients were included if they had been discharged with a diagnosis of IFI due to or , which was culture proven or suspected based on clinical criteria. Hospital data were abstracted for a random sample of patients to capture demographics, treatment patterns, hospital resource utilization, and clinical outcomes. Descriptive results were reported.
Five hospitals participated and provided data on 102 patients with IFI (51 from Lebanon and 51 from Saudi Arabia). The mean age of the patients was 55 years, and 55% were males. Comorbidities included diabetes (41%), coronary artery disease (24%), leukemia (19%), moderate-to-severe renal disease (16%), congestive heart failure (15%), and chronic obstructive pulmonary disease (15%). Twenty percent of patients received corticosteroids prior to admission and 26% had received chemotherapy in the past 90 days. Inpatient mortality was 42%, and the mean hospital length of stay was 32.4±28.6 days. Fifty-five percent of patients required intensive care unit admission (17.2±14.1 days), 37% required mechanical ventilation (13.7±13.2 days), and 11% required dialysis (14.6±14.2 days). The most commonly used first-line antifungal was fluconazole.
Patients with IFI in Saudi Arabia and Lebanon frequently have multiple medical comorbidities and may not have traditionally observed IFI risk factors. Efforts to increase use of rapid diagnostic tests and appropriate antifungal treatments may impact the substantial mortality and high length of stay observed in these patients.
本研究的目的是记录沙特阿拉伯和黎巴嫩因[具体菌种1]和[具体菌种2]导致的侵袭性真菌感染（IFI）的负担及治疗模式。
采用回顾性病历审查研究，使用2011年至2012年沙特阿拉伯和黎巴嫩医院记录的数据。如果患者出院时诊断为因[具体菌种1]或[具体菌种2]导致的IFI，且经培养证实或根据临床标准怀疑，则纳入研究。对患者的随机样本提取医院数据，以获取人口统计学信息、治疗模式、医院资源利用情况和临床结果。报告描述性结果。
五家医院参与并提供了102例IFI患者的数据（51例来自黎巴嫩，51例来自沙特阿拉伯）。患者的平均年龄为55岁，55%为男性。合并症包括糖尿病（41%）、冠状动脉疾病（24%）、白血病（19%）、中重度肾病（16%）、充血性心力衰竭（15%）和慢性阻塞性肺疾病（15%）。20%的患者在入院前接受过皮质类固醇治疗，26%的患者在过去90天内接受过化疗。住院死亡率为42%，平均住院时间为32.4±28.6天。55%的患者需要入住重症监护病房（17.2±14.1天），37%的患者需要机械通气（13.7±13.2天），11%的患者需要透析（14.6±14.2天）。最常用的一线抗真菌药物是氟康唑。
沙特阿拉伯和黎巴嫩的IFI患者常有多种合并症，可能未传统地观察到IFI危险因素。增加快速诊断检测的使用和适当抗真菌治疗的努力可能会影响这些患者中观察到的高死亡率和长住院时间。
