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二十一世纪全球真菌性传染病的皮肤表现,可能使人类共同面临的 COVID-19 大流行更加复杂。

Cutaneous manifestations of a 21st century worldwide fungal epidemic possibly complicating the COVID-19 pandemic to jointly menace mankind.

机构信息

Dermatology, Medicine, and Pathology, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

出版信息

Dermatol Ther. 2020 Jul;33(4):e13481. doi: 10.1111/dth.13481. Epub 2020 May 27.

DOI:10.1111/dth.13481
PMID:32369240
Abstract

In view of the new viral COVID-19 pandemic, the fungal Candida auris epidemic still in progress worldwide highlights non-Candida albicans candidal infections. We describe an immunocompetent woman with a cutaneous manifestation of Candida parasilopsis fungemia, a prominent eschar, which proved to be the nidus for the candidemia. We stress the value of selectively removing eschars. C. parasilopsis and C. auris are increasingly important causes of sepsis and wound infections. We emphasize that commercially available biochemical-based tests may misidentify C. auris as C. parapsilosis, and stress the added danger of C. auris to critically ill-hospitalized COVID-19 patients. Any health care facility with evidence of infection or colonization with C. auris requires very close monitoring, since this fungus is a nosocomial threat comparable to SARS-CoV-2 in its mortality and fomite adhesiveness! Both organisms have the potential to be transmitted as nosocomial pathogens; health care workers need to follow strict CDC guidelines. During this COVID-19 pandemic, every health care facility should closely monitor for the possible deadly combination of the SARS-CoV-2 and C. auris. The identification of C. auris necessitates use of sophisticated technology not readily available to make this essential diagnosis since C. auris is multi-drug resistant and isolation precautions would become paramount.

摘要

鉴于新的病毒性 COVID-19 大流行,真菌假丝酵母菌在全球范围内的流行仍在继续,这突显了非白假丝酵母菌假丝酵母菌感染。我们描述了一位免疫功能正常的妇女患有假丝酵母菌菌血症的皮肤表现,有一个明显的焦痂,事实证明这是菌血症的病灶。我们强调选择性去除焦痂的重要性。假丝酵母菌和假丝酵母菌假丝酵母菌是败血症和伤口感染的重要原因。我们强调,市售的基于生化的检测方法可能会错误地将假丝酵母菌鉴定为假丝酵母菌假丝酵母菌,并强调假丝酵母菌假丝酵母菌对 COVID-19 重症住院患者的额外危险。任何有假丝酵母菌感染或定植证据的医疗机构都需要密切监测,因为这种真菌是一种医院获得性威胁,其死亡率和污染物黏附性可与 SARS-CoV-2 相媲美!这两种生物体都有可能作为医院获得性病原体传播;医护人员需要遵循严格的 CDC 指南。在 COVID-19 大流行期间,每个医疗机构都应密切监测 SARS-CoV-2 和假丝酵母菌假丝酵母菌可能致命的组合。由于假丝酵母菌假丝酵母菌具有多药耐药性,并且需要采取隔离措施,因此需要使用不易获得的复杂技术来进行鉴定,这对于做出这一重要诊断至关重要。

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