Muñoz P, Vena A, Padilla B, Valerio M, Sanchez M I, Puig-Asensio M, Fortún J, Fernández-Ruiz M, Merino P, Losa J E, Loza A, Rivas R A, Bouza E
Clinical Microbiology and Infectious Disease Division, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Gregorio Marañón, Madrid, Spain; CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), Madrid, Spain; Medicine Department, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.
Clinical Microbiology and Infectious Disease Division, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Instituto de Investigación Sanitaria Hospital Gregorio Marañón, Madrid, Spain.
Diagn Microbiol Infect Dis. 2017 Jun;88(2):141-144. doi: 10.1016/j.diagmicrobio.2017.02.014. Epub 2017 Feb 27.
Candins are commonly used as initial therapy in patients with candidemia and are known to diffuse poorly into ocular tissue. The aim of our multicenter study was to assess whether eye involvement was more common in patients initially treated with echinocandins. We performed a post hoc analysis of a prospective, multicenter, population-based candidemic surveillance program implemented in Spain during 2010-2011 (CANDIPOP project). Eye involvement was detected in 13 of 168 patients with candidemia (7.7%) who underwent ophthalmoscopy. Two patients had endophthalmitis, while the remaining patients had chorioretinitis. The frequency of ocular candidiasis was similar in patients receiving initial therapy with candins (3/56; 5.4%) or with other regimens (10/112; 8.9%). At multivariate analysis, risk conditions for eye involvement were dialysis after candidemia (OR, 19.4; 95% CI, 1.7-218.4) and involvement of organs other than the eye (OR, 5.4; 95% CI, 1.1-25.7). In conclusion, eye involvement was not found to be more frequent in patients receiving initial therapy with echinocandins than in patients receiving other drugs.
棘白菌素常用于念珠菌血症患者的初始治疗，且已知其在眼组织中的扩散较差。我们多中心研究的目的是评估在最初接受棘白菌素治疗的患者中眼部受累是否更常见。我们对2010 - 2011年在西班牙实施的一项前瞻性、多中心、基于人群的念珠菌血症监测项目（CANDIPOP项目）进行了事后分析。在168例接受眼底镜检查的念珠菌血症患者中，有13例（7.7%）检测到眼部受累。2例患者患有眼内炎，其余患者患有脉络膜视网膜炎。接受棘白菌素初始治疗的患者（3/56；5.4%）与接受其他治疗方案的患者（10/112；8.9%）眼部念珠菌病的发生率相似。在多变量分析中，眼部受累的风险因素为念珠菌血症后进行透析（比值比，19.4；95%置信区间，1.7 - 218.4）以及眼外器官受累（比值比，5.4；95%置信区间，1.1 - 25.7）。总之，未发现接受棘白菌素初始治疗的患者比接受其他药物治疗的患者眼部受累更频繁。
