新兴的多重耐药念珠菌物种。

Emerging multidrug-resistant Candida species.

机构信息

aDivision of Infectious Diseases, Department of Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo bCentral Laboratory Division (LIM03), Laboratory of Medical Mycology (LIM53), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil cMedicine Department, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, CIBER Enfermedades Respiratorias-CIBERES (CB06/06/0058), School of Medicine, Universidad Complutense de Madrid, Madrid, Spain.

出版信息

Curr Opin Infect Dis. 2017 Dec;30(6):528-538. doi: 10.1097/QCO.0000000000000411.

DOI:10.1097/QCO.0000000000000411

PMID:29095200

Abstract

PURPOSE OF REVIEW

To describe the epidemiology, strategies for early detection, and clinical management of infections caused by the most commonly found multidrug-resistant (MDR) Candida spp.

RECENT FINDINGS

Increasing numbers of reports describing invasive infections by MDR Candida auris and Candida glabrata has been reported in medical centers worldwide.

SUMMARY

We checked all papers published along the last 10 years describing epidemiological, diagnostic, and clinical aspects of infections by MDR Candida spp., with emphasis on C. auris and C. glabrata spp. C. auris has been reported in 15 countries and multidrug resistance rates is usually above 30%. Horizontal transmission is a great concern regarding C. auris. C. glabrata ranks the second most reported Candida spp. in deep-seated infections from United States and some European Centers, although multidrug resistance rates above 10% are restricted to some US centers. Candida haemulonii complex isolates with poor susceptibility to azoles and amphotericin B have been isolated in superficial and deep-seated infections, whereas Candida guilliiermondii complex isolates with poor susceptibility to azoles and echinocandins have been recovered from catheter-related bloodstream infections. Other potential MDR Candida species are Candida krusei, Candida lusitaniae, Candida kefyr, Yarrowia (Candida) lypolitica, and Candida rugosa.

摘要

目的综述

描述最常见的多药耐药（MDR）念珠菌属引起的感染的流行病学、早期检测策略和临床管理。

总结

我们查阅了过去 10 年中所有描述 MDR 念珠菌属感染的流行病学、诊断和临床方面的论文，重点关注 C. auris 和 C. glabrata 属。C. auris 已在 15 个国家报告，其多药耐药率通常高于 30%。C. auris 的水平传播是一个令人关注的问题。C. glabrata 是美国和一些欧洲中心深部感染报告第二多的念珠菌属，尽管多药耐药率高于 10%仅限于一些美国中心。在浅表和深部感染中分离出对唑类和两性霉素 B 敏感性差的近平滑念珠菌属复合种，而在导管相关血流感染中分离出对唑类和棘白菌素类敏感性差的假热带念珠菌属复合种。其他潜在的 MDR 念珠菌属包括光滑念珠菌、葡萄牙念珠菌、克柔念珠菌、酵母（念珠菌属） lipolitica 和皱褶念珠菌。