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成人侵袭性真菌病的发病率:哥伦比亚麦德林一家专业实验室的经验(2009 - 2015年)

Frequency of Invasive Fungal Disease in Adults: Experience of a Specialized Laboratory in Medellín, Colombia (2009-2015).

作者信息

Valencia Yorlady, Cáceres Diego H, de Bedout Catalina, Cano Luz E, Restrepo Ángela

机构信息

Medical and Experimental Mycology Unit, Corporación para Investigaciones Biológicas (CIB), Medellín 050036, Colombia.

Mycotic Diseases Branch, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA.

出版信息

J Fungi (Basel). 2020 Mar 20;6(1):39. doi: 10.3390/jof6010039.

Abstract

Invasive fungal diseases (IFD) contribute significantly to worldwide morbidity and mortality, but their frequency is not well-described in some countries. The present work describes the frequency of IFD in a specialized laboratory in Colombia. A retrospective, descriptive study was implemented between March 2009 and December 2015. Results: 13,071 patients with clinical suspicion of IFD were referred during the study period, from which 33,516 biological samples were processed and analyzed using 14 laboratory methods. Diagnosis was confirmed in 1425 patients (11%), distributed according to the mycoses of interest analyzed here: histoplasmosis in 641/11,756 patients (6%), aspergillosis in 331/10,985 patients (3%), cryptococcosis in 239/8172 patients (3%), pneumocystosis in 111/1651 patients (7%), paracoccidioidomycosis in 60/10,178 patients (0.6%), and invasive candidiasis in 48/7525 patients (0.6%). From the first year of the study period to the last year, there was a 53% increase in the number of cases of IFD diagnosed. Our laboratory experienced a high frequency of IFD diagnosis, possibly attributable to the availability of a greater range of diagnostic tools. Frequency of IFD in this study was atypical compared with other studies, probably as a result of the single laboratory-site analysis. This demonstrates that implementing educational strategies helps to create a high index of clinical suspicion, while the availability and utilization of appropriate diagnostic assays assure greater reliability in identification of these cases.

摘要

侵袭性真菌病(IFD)在全球范围内对发病率和死亡率有重大影响,但在一些国家其发病频率尚无确切描述。本研究描述了哥伦比亚一家专业实验室中IFD的发病频率。2009年3月至2015年12月期间开展了一项回顾性描述性研究。结果:研究期间共转诊了13071例临床怀疑患有IFD的患者,对其33516份生物样本采用14种实验室方法进行了处理和分析。1425例患者(11%)确诊,根据本文分析的相关真菌病分布如下:11756例患者中有641例(6%)患有组织胞浆菌病,10985例患者中有331例(3%)患有曲霉病,8172例患者中有239例(3%)患有隐球菌病,1651例患者中有111例(7%)患有肺孢子菌病,10178例患者中有60例(0.6%)患有副球孢子菌病,7525例患者中有48例(0.6%)患有侵袭性念珠菌病。从研究期的第一年到最后一年,确诊的IFD病例数增加了53%。我们实验室IFD诊断频率较高,这可能归因于有更多种类的诊断工具。与其他研究相比,本研究中IFD的频率不典型,可能是由于仅对单个实验室的数据进行分析。这表明实施教育策略有助于提高临床怀疑指数,而适当诊断检测方法的可用性和应用可确保在识别这些病例时具有更高的可靠性。

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