Departments of Pathology and Medicine, Aga Khan University, Third Parklands Rd., Nairobi, Kenya.
Department of Pathology, Aga Khan University, Third Parklands Rd., Nairobi, Kenya.
Int J Infect Dis. 2019 Aug;85:182-187. doi: 10.1016/j.ijid.2019.06.001. Epub 2019 Jun 8.
Candida auris emerged as a human pathogen in 2009 and has subsequently been identified around the world as a cause of invasive candidiasis. We did an analysis from a single institution in order to analyze risk factors and outcomes for C. auris candidemia.
Patients with candidemia were identified by the electronic medical record and reviewed for risk factors and outcome. Candida isolates were identified by Vitek2 as Candida haemulonii, but species determinations for 21 of the isolates using published molecular and proteomic methods identified all as C. auris.
From September 2010 to December 2016, C. auris accounted for 38% of 201 patients with candidemia, while C. albicans contributed 25%. C. auris patients had been hospitalized longer (mean 32 days vs. 13 days; p<0.001), were more likely to have central lines preceding candidemia than C. albicans patients (84% vs. 54%; p=<0.001) and had more commonly been treated with carbapenems (83% vs 61% for C. albicans [p=0.01]). The crude mortality was 29%, compared to 36% for C. albicans.
These findings suggest an opportunistic pathogen that may be less virulent, but difficult to eradicate and that control efforts should focus on antimicrobial usage.
耳念珠菌于 2009 年被发现为一种人类病原体，随后在全球范围内被确定为侵袭性念珠菌病的病因。我们对一家医疗机构进行了分析，以分析耳念珠菌血症的危险因素和结局。
通过电子病历识别出念珠菌血症患者，并对其进行危险因素和结局的回顾。使用 Vitek2 将念珠菌分离株鉴定为溶血假丝酵母，但使用已发表的分子和蛋白质组学方法对 21 株分离株进行的种属鉴定，均确定为耳念珠菌。
2010 年 9 月至 2016 年 12 月，耳念珠菌占 201 例念珠菌血症患者的 38%，而白色念珠菌占 25%。耳念珠菌血症患者的住院时间更长（平均 32 天 vs. 13 天；p<0.001），与白色念珠菌血症患者相比，更有可能在念珠菌血症发生前有中央导管（84% vs. 54%；p=<0.001），更常接受碳青霉烯类药物治疗（83% vs. 61%用于白色念珠菌[ p=0.01]）。粗死亡率为 29%，而白色念珠菌血症为 36%。
这些发现表明耳念珠菌是一种机会性病原体，可能毒性较低，但难以根除，控制措施应重点关注抗菌药物的使用。
