Mohsin Jalila, Weerakoon Sanjeewani, Ahmed Sarah, Puts Ynze, Al Balushi Zainab, Meis Jacques F, Al-Hatmi Abdullah M S
Department of Microbiology, Royal Hospital, Ministry of Health, 111 Muscat, Oman.
Foundation Atlas of Clinical Fungi, 1214 GP Hilversum, The Netherlands.
Antibiotics (Basel). 2020 Sep 24;9(10):638. doi: 10.3390/antibiotics9100638.
(1) Background: has been reported as emerging yeast pathogen that can cause invasive bloodstream infections in healthcare settings. It is associated with high mortality rates and resistance to multiple classes of antifungal drugs and is difficult to identify with standard laboratory methods. (2) Methods: We conducted a retrospective review of epidemiological, clinical, and microbiological records for 23 fungemia cases at the Royal Hospital, a tertiary care facility in Oman, between 2016 and 2018. Demographic data, risk factors associated with mortality, microbiology investigation and treatment regimens are described. Yeasts were identified by MALDI-TOF. (3) Results: We identified 23 patients with fungemia. All positive samples from patients were confirmed as using MALDI-TOF, and ITS-rDNA sequencing. Microsatellite genotyping showed that the Omani isolates belong to the South Asian clade I. The majority of patients had multiple underlying illnesses and other risk factors that have been associated with fungemia. All isolates were non-susceptible to fluconazole. Isolates from all patients were sensitive to echinocandins and these were used as first line therapy. (4) Conclusions: affects adults and children with a variety of risk factors including central venous catheters and overuse of antibiotics. Infections occur in both immunocompromised and immunocompetent individuals. Mortality was high in this series, and the organism can be transmitted in healthcare settings. Programs for raising awareness in Oman hospitals are warranted. Caspofungin remains 1st line therapy as MICs are still low despite its wide use.
(1) 背景：已被报道为一种新兴的酵母病原体，可在医疗环境中引起侵袭性血流感染。它与高死亡率以及对多类抗真菌药物的耐药性相关，并且难以用标准实验室方法进行鉴定。(2) 方法：我们对阿曼一家三级医疗设施皇家医院2016年至2018年间23例真菌血症病例的流行病学、临床和微生物学记录进行了回顾性研究。描述了人口统计学数据、与死亡率相关的危险因素、微生物学调查和治疗方案。通过基质辅助激光解吸电离飞行时间质谱（MALDI-TOF）鉴定酵母。(3) 结果：我们确定了23例真菌血症患者。患者的所有阳性样本通过MALDI-TOF和内转录间隔区核糖体DNA（ITS-rDNA）测序确认为[具体真菌名称未给出]。微卫星基因分型显示阿曼分离株属于南亚进化枝I。大多数患者有多种基础疾病和其他与真菌血症相关的危险因素。所有分离株对氟康唑不敏感。所有患者的分离株对棘白菌素敏感，这些被用作一线治疗。(4) 结论：[具体真菌名称未给出]影响有多种危险因素的成人和儿童，包括中心静脉导管和抗生素的过度使用。感染发生在免疫功能低下和免疫功能正常的个体中。本系列中的死亡率很高，并且该病原体可在医疗环境中传播。阿曼医院有必要开展提高认识的项目。尽管卡泊芬净广泛使用但其最低抑菌浓度（MIC）仍然较低，因此仍是一线治疗药物。
