Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China.
National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, 110001, China.
Mycopathologia. 2020 Dec;185(6):975-982. doi: 10.1007/s11046-020-00485-2. Epub 2020 Sep 28.
Although Meyerozyma guilliermondii complex is an uncommon cause of invasive candidiasis worldwide, reported cases, mainly regarding bloodstream infections, increased over years, and patients with cancer who have undergone recent surgery are most commonly affected. However, the clinical characteristics and outcomes of candidemia caused by M. guilliermondii complex remain poorly understood. A retrospective case-control study was conducted to evaluate the clinical characteristics and mortality of candidemia caused by M. guilliermondii complex in cancer patients undergoing surgery. Demographic and clinical data were collected from the hospital medical records system with a standardized data collection form and were analyzed with SPSS 20.0. Sixty-six cancer patients who have undergone recent surgery and were diagnosed with candidemia caused by M. guilliermondii complex were included in the study. Regarding the clinical manifestations, most patients' body temperatures ranged from 38 to 40 °C, with a median fever duration of 4 (IQR: 3-6) days. Multivariate analysis indicated that the presence of central venous catheter (OR: 6.68; 95% CI 2.80-15.94) and gastric tube (OR: 3.55; 95% CI 1.22-10.34) were independent risk factors for M. guilliermondii complex fungemia. The 30-day crude mortality of candidemia caused by M. guilliermondii complex was 12.1%, twice that of the control group. Moreover, increased WBC count, age ≥ 60 years, septic shock, and ICU admission were identified as predictors of mortality through univariate analysis. These findings will provide a foundation for the clinical management of candidemia caused by M. guilliermondii complex in post-surgical cancer patients.
虽然梅里埃毕赤酵母复合群是全球侵袭性念珠菌病的不常见原因，但近年来，报道的病例主要涉及血流感染，有所增加，并且最近接受过手术的癌症患者最常受到影响。然而，梅里埃毕赤酵母复合群引起的念珠菌血症的临床特征和结局仍了解甚少。本研究进行了一项回顾性病例对照研究，以评估接受手术的癌症患者中由梅里埃毕赤酵母复合群引起的念珠菌血症的临床特征和死亡率。从医院病历系统中使用标准化数据收集表收集人口统计学和临床数据，并使用 SPSS 20.0 进行分析。本研究纳入了 66 例最近接受过手术且诊断为梅里埃毕赤酵母复合群引起的念珠菌血症的癌症患者。关于临床表现，大多数患者的体温在 38 至 40°C 之间，中位数发热持续时间为 4（IQR：3-6）天。多变量分析表明，中央静脉导管（OR：6.68；95%CI 2.80-15.94）和胃管（OR：3.55；95%CI 1.22-10.34）的存在是梅里埃毕赤酵母复合群菌血症的独立危险因素。梅里埃毕赤酵母复合群引起的念珠菌血症的 30 天粗死亡率为 12.1%，是对照组的两倍。此外，通过单因素分析发现，白细胞计数增加、年龄≥60 岁、感染性休克和入住 ICU 是死亡的预测因素。这些发现将为术后癌症患者中由梅里埃毕赤酵母复合群引起的念珠菌血症的临床管理提供基础。
