儿童和成人真菌血症患者中酵母菌分离株的检测时间及其与临床特征和结局的相关性。
Time to Detection of Yeast Isolates in Pediatric and Adult Patients with Fungemia and its Relevance to Clinical Profile and Outcome.
作者信息
Butta Hena, Sardana Raman, Mendiratta Leena, Sibal Anupam, Gupta Vidya, Chawla Rajesh, Jafri Ali Ammar
机构信息
Departments of Microbiology, Indraprastha Apollo Hospitals, New Delhi, India.
Departments of Pediatrics, Indraprastha Apollo Hospitals, New Delhi, India.
出版信息
Indian J Crit Care Med. 2019 Jan;23(1):27-30. doi: 10.5005/jp-journals-10071-23108.
CONTEXT
Time to detection (TTD) given by continuous monitoring automated blood culture systems (CMABS) have been found to be a predictor of clinical outcome, drug resistance and type of microorganism in cases of bacteremia but the studies evaluating TTD with respect to fungemia are scarce especially from India.
AIMS
To evaluate TTD for yeast isolates in fungal bloodstream infections with respect to the type of yeast isolates, risk factors and outcome and to study yeast susceptibility and distribution of yeast isolates with respect to patient population.
MATERIALS AND METHODS
All blood culture specimens were processed in CMABS. The TTD for yeast isolates were recorded. The identification of yeast and susceptibility testing was done by automated methods. A correlation of TTD was done with respect to prior/concurrent yeast isolates, use of antifungal, risk factors and clinical outcome.
RESULTS
Out of 80 yeast isolates, the maximum was (26.25%) followed by (16.25%) and (13.75%). A statistically significant difference in the occurrence of yeasts with early TTD (TTD < = 48 hours) and late TTD (TTD > 48 hours) was found. TTD of was significantly longer (p = 0.002) while TTD of was significantly shorter (p = 0.013). There was an observable favorable outcome in shorter TTD (< = 48 hours). and depicted 100% susceptibility for Azoles, Amphotericin B and Echinocandins.
CONCLUSION
TTD may be used as both diagnostic and prognostic adjunct in fungal bloodstream infections. This study is a step towards this novel approach. We also emphasize on the importance of speciation of yeast isolates and susceptibility testing.
HOW TO CITE THIS ARTICLE
Butta H, Sardana R, Mendiratta L, Sibal A, Gupta V, Chawla R, Jafri AA. Time to Detection of Yeast Isolates in Pediatric and Adult Patients with Fungemia and its Relevance to Clinical Profile and Outcome. Indian Journal of Critical Care Medicine, January 2019;23(1):27-30.
背景
连续监测自动血培养系统（CMABS）给出的检测时间（TTD）已被发现是菌血症病例中临床结局、耐药性和微生物类型的预测指标，但评估TTD与真菌血症相关性的研究很少，尤其是来自印度的研究。
目的
评估真菌血流感染中酵母分离株的TTD与酵母分离株类型、危险因素和结局的关系，并研究酵母对患者群体的易感性和酵母分离株的分布情况。
材料与方法
所有血培养标本均在CMABS中处理。记录酵母分离株的TTD。通过自动化方法进行酵母鉴定和药敏试验。对TTD与先前/同时存在的酵母分离株、抗真菌药物的使用、危险因素和临床结局进行相关性分析。
结果
在8株酵母分离株中，最多的是（26.25%），其次是（16.25%）和（13.75%）。发现早期TTD（TTD <= 48小时）和晚期TTD（TTD > 48小时）的酵母发生率存在统计学显著差异。的TTD显著更长（p = 0.002），而的TTD显著更短（p = 0.013）。较短的TTD（<= 48小时）有明显更好的结局。和对唑类、两性霉素B和棘白菌素显示出100%的敏感性。
结论
TTD可作为真菌血流感染的诊断和预后辅助指标。本研究是朝着这种新方法迈出的一步。我们还强调了酵母分离株的菌种鉴定和药敏试验的重要性。
如何引用本文
Butta H, Sardana R, Mendiratta L, Sibal A, Gupta V, Chawla R, Jafri AA. 儿童和成人真菌血症患者酵母分离株的检测时间及其与临床特征和结局的相关性。《印度重症监护医学杂志》，2019年1月；23(1):27 - 30。
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