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2007 - 2014年土耳其一所三级护理大学医院念珠菌血症的流行病学、菌种分布、临床特征及死亡率

Epidemiology, species distribution, clinical characteristics and mortality of candidaemia in a tertiary care university hospital in Turkey, 2007-2014.

作者信息

Yeşilkaya Ayşegül, Azap Özlem, Aydın Mehtap, Akçil Ok Mehtap

机构信息

Faculty of Medicine, Department of Infectious Diseases and Clinical Microbiology, Baskent University, Ankara, Turkey.

Faculty of Health Sciences, Department of Nutrition and Dietetic, Baskent University, Ankara, Turkey.

出版信息

Mycoses. 2017 Jul;60(7):433-439. doi: 10.1111/myc.12618. Epub 2017 Mar 24.

Abstract

Candidaemia still continues to be a serious medical concern and the epidemiology of candidaemia varies according to geographical areas. We aim to determine the incidence, local epidemiology, Candida species distribution and crude mortality rates of candidaemia. We retrospectively evaluated candidaemia episodes in between January 2007 and August 2014. We compared demographic, clinical, microbiological findings and mortality rates of episodes caused by Candida albicans and non-albicans Candida species. Overall the candidaemia incidences were 1.23 episodes/1000 admissions. A significant negative slope among candidaemia episodes and years was determined. Overall C. albicans (54.6%) was the most common species followed by Candida glabrata, Candida tropicalis and Candida parapsilosis respectively. Preinfection hospital stay and length of hospital stay were statistically longer in patients with non-albicans Candida candidaemia than in patients with C. albicans candidaemia. The source of candidaemia was unknown in 52.5% of all episodes. Central venous catheters among non-albicans Candida candidaemia episodes and urinary system among C. albicans candidaemia episodes were common source of candidaemia compared to each other. Previous antifungal therapy preceding candidaemia and concomitant bacteraemia were significantly associated with non-albicans Candida candidaemia. Continuous local surveillance will preserve its pivotal importance in formulating empirical antifungal therapy and improving management of candidaemia.

摘要

念珠菌血症仍然是一个严重的医学问题,并且念珠菌血症的流行病学因地理区域而异。我们旨在确定念珠菌血症的发病率、当地流行病学、念珠菌种类分布及粗死亡率。我们回顾性评估了2007年1月至2014年8月期间的念珠菌血症发作情况。我们比较了由白色念珠菌和非白色念珠菌引起的发作的人口统计学、临床、微生物学结果及死亡率。总体而言,念珠菌血症发病率为1.23例/1000次入院。确定了念珠菌血症发作次数与年份之间存在显著的负斜率。总体而言,白色念珠菌(54.6%)是最常见的菌种,其次分别是光滑念珠菌、热带念珠菌和近平滑念珠菌。非白色念珠菌念珠菌血症患者的感染前住院时间和住院时间在统计学上比白色念珠菌念珠菌血症患者更长。在所有发作中,52.5%的念珠菌血症来源不明。与彼此相比,非白色念珠菌念珠菌血症发作中的中心静脉导管和白色念珠菌念珠菌血症发作中的泌尿系统是念珠菌血症的常见来源。念珠菌血症之前的抗真菌治疗及合并菌血症与非白色念珠菌念珠菌血症显著相关。持续的局部监测在制定经验性抗真菌治疗和改善念珠菌血症管理方面仍将保持其关键重要性。

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