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侵袭性念珠菌病患者的 T2Candida 磁共振:优势与局限性。

T2Candida magnetic resonance in patients with invasive candidiasis: Strengths and limitations.

机构信息

Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria.

Division of General Paediatrics, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria.

出版信息

Med Mycol. 2020 Jul 1;58(5):632-638. doi: 10.1093/mmy/myz101.

Abstract

T2Candida enables detection of five Candida species in whole blood within approximately 5 hours. Routinely drawn EDTA blood samples were prospectively stored and tested with T2Candida in patients with invasive candidiasis identified by routine index blood or sterile site cultures. T2Candida was compared to diagnostic blood and sterile site cultures and also performed with samples obtained prior and after collection of index cultures. T2Candida was evaluated with 133 samples of 32 patients with candidemia and 22 patients with deep-seated invasive candidiasis. In the candidemic group 28/32 (87.5%) patients had at least one positive T2Candida result at any time point. A total of 17/25 (68%) candidemic patients had a positive T2Candida sample that was drawn concurrently to the index blood culture. In the per patient analysis 17/18 (94.4%) candidemic patients with matched T2Candida samples and peripheral blood cultures at any timepoint had a positive T2Candida test. T2Candida revealed discordant Candida species identification in two candidemic patients. Six of 22 (27.3%) deep-seated IC patients had a positive T2Candida result. Despite advanced time-to-results the clinical value of T2Candida in diagnosing candidemia seems to be limited by missing blood culture positive cases. Positivity rates of T2Candida increased when serial T2Candida samples were tested. In patients with suspected deep-seated invasive candidiasis T2Candida might act as a blood based adjunct to sterile site cultures.

摘要

T2Candida 可在大约 5 小时内检测全血中的五种念珠菌。对疑似侵袭性念珠菌病患者,常规采集 EDTA 血样,前瞻性储存并采用 T2Candida 进行检测。T2Candida 与诊断性血液和无菌部位培养物进行了比较,也与采集索引培养物之前和之后的样本进行了比较。对 32 例念珠菌血症患者和 22 例深部侵袭性念珠菌病患者的 133 份样本进行了 T2Candida 评估。在念珠菌血症组中,28/32(87.5%)例患者在任何时间点至少有一次 T2Candida 阳性结果。共有 17/25(68%)例念珠菌血症患者的 T2Candida 样本与索引血培养同时呈阳性。在每位患者的分析中,17/18(94.4%)例有匹配的 T2Candida 样本和外周血培养物的念珠菌血症患者在任何时间点 T2Candida 检测均为阳性。T2Candida 在两名念珠菌血症患者中显示出不一致的念珠菌种鉴定。22 例深部 IC 患者中有 6 例(27.3%)T2Candida 检测结果阳性。尽管 T2Candida 的结果出现时间较晚,但在诊断念珠菌血症方面,其临床价值似乎受到血培养阳性病例缺失的限制。当连续检测 T2Candida 样本时,T2Candida 的阳性率增加。对于疑似深部侵袭性念珠菌病的患者,T2Candida 可能作为无菌部位培养物的血液辅助检测方法。

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