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从一家三级医院的血培养中分离出粘红酵母。

Isolation of Rhodotorula mucilaginosa from blood cultures in a tertiary care hospital.

机构信息

Clinical Microbiology Department, Hospital Universitario La Paz, Madrid, Spain.

出版信息

Mycoses. 2018 Jan;61(1):35-39. doi: 10.1111/myc.12703. Epub 2017 Oct 13.

Abstract

Rhodotorula species have traditionally been considered as one of common non-virulent environmental inhabitant. They have emerged as an opportunistic pathogen, particularly in immunocompromised hosts and most infections have been associated with intravenous catheters in these patients. We review the isolates in blood cultures of Rhodotorula mucilaginosa in our Hospital. We describe the demographic and clinical features of the cases and the antifungal susceptibility profiles of the isolates. Selected patients had an isolation of R. mucilaginosa in blood cultures in our tertiary care Hospital. All data were collected retrospectively from clinical records during 5 years. We report 8 isolates in blood, two of them were considered contaminants. Immunosuppression, surgery, previous antibiotic therapy were common clinical features. For all the isolates, minimum inhibitory concentration (MIC) values were high for echinocandins and azoles and low for amphotericin B and 5-flucytosine. One strain showed atypical susceptibility profile. Rhodotorula mucilaginosa may be present on the skin and blood cultures can be contaminated. Fungaemia due to R. mucilaginosa is a rare clinical entity which requires risk factors but clinically relevant because of the multiresistant profile. Rhodotorula mucilaginosa shows high MIC values for azoles and echinocandins, therefore amphotericin B and flucytosine must be administered as antifungal therapy.

摘要

红酵母属通常被认为是一种常见的非毒性环境栖息菌。它们已成为一种机会致病菌,特别是在免疫功能低下的宿主中,大多数感染与这些患者的静脉导管有关。我们回顾了我院血培养中粘红酵母的分离株。我们描述了病例的人口统计学和临床特征以及分离株的抗真菌药敏谱。在我们的三级保健医院,一些选定的患者血液中分离出粘红酵母。所有数据均来自 5 年内的临床记录进行回顾性收集。我们报告了 8 例血培养中的分离株,其中 2 例被认为是污染菌。免疫抑制、手术、先前的抗生素治疗是常见的临床特征。对于所有分离株,棘白菌素类和唑类的最低抑菌浓度(MIC)值较高,两性霉素 B 和 5-氟胞嘧啶的 MIC 值较低。一株表现出非典型的药敏谱。粘红酵母可能存在于皮肤和血液培养物中,可能被污染。由于粘红酵母引起的真菌血症是一种罕见的临床实体,需要有危险因素,但由于其耐药谱,临床上具有相关性。粘红酵母对唑类和棘白菌素类的 MIC 值较高,因此必须使用两性霉素 B 和氟胞嘧啶进行抗真菌治疗。

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