Clinica Malattie Infettive, Ospedale Policlinico San Martino - IRCCS, Genoa, Italy.
Department of Health Sciences, University of Genoa, Genoa, Italy.
Mycoses. 2020 Apr;63(4):334-342. doi: 10.1111/myc.13054.
Candidaemia remains associated with high mortality and increased costs worldwide.
To assess the changes over time in the relative prevalence of non-albicans candidaemia (NAC).
A systematic review, meta-analysis and meta-regression were performed. Observational studies investigating the epidemiology of consecutive, non-selected, candidaemia episodes were included. Two separated analyses were conducted: (a) whole hospital analysis and (b) intensive care unit (ICU) analysis.
Starting from an initial total of 7726 records, 220 studies fulfilled inclusion criteria. The pooled prevalence of NAC in whole hospital analysis was 49.5% (95% confidence intervals [CI] 48.0-51.1, I 93.1%), while the pooled prevalence in ICU analysis was 50.6% (95% CI 46.6-54.6; I 86.7%). In meta-regression, a progressive increase in NAC prevalence was observed in whole hospital analysis, although it explained only a small portion of between-study variance (estimated yearly prevalence change +0.3%, 95% CI from +0.1% to +0.5%, P = .003; adjusted R 3.42%) and was observed only in some continents in subgroup analyses. No relevant changes over time were observed in NAC prevalence for ICU studies.
We registered an increasing trend in the relative prevalence of NAC, which, nonetheless, seems to be limited to some continents and to contribute only minimally to explain the observed differences in NAC prevalence across studies.
念珠菌血症仍然与全球范围内的高死亡率和增加的成本相关。
评估非白念珠菌性念珠菌血症（NAC）相对流行率随时间的变化。
进行了系统评价、荟萃分析和荟萃回归。纳入了研究连续、非选择性念珠菌血症发作的流行病学的观察性研究。进行了两次独立的分析：（a）全院分析和（b）重症监护病房（ICU）分析。
从最初的 7726 条记录中，有 220 项研究符合纳入标准。全院分析中 NAC 的总流行率为 49.5%（95%置信区间[CI]48.0-51.1，I 93.1%），而 ICU 分析中的流行率为 50.6%（95%CI46.6-54.6；I 86.7%）。在荟萃回归中，尽管仅解释了研究间差异的一小部分（估计每年流行率变化+0.3%，95%CI 从+0.1%到+0.5%，P=.003；调整后的 R 3.42%），但在全院分析中观察到 NAC 流行率呈渐进性增加，且仅在一些大陆的亚组分析中观察到。ICU 研究中 NAC 流行率未观察到随时间的相关变化。
我们记录到 NAC 相对流行率呈上升趋势，但这种趋势似乎仅限于某些大陆，并且仅对解释研究中 NAC 流行率的差异贡献极小。
