Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea; Division of Infectious Diseases, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul 02841, Republic of Korea.
J Mycol Med. 2021 Mar;31(1):101102. doi: 10.1016/j.mycmed.2020.101102. Epub 2020 Dec 1.
Endogenous fungal endophthalmitis (EFE) is a critical complication of candidemia. We conducted a study to investigate the prevalence and risk factors for EFE.
Adult candidemia patients≥19years who underwent an ophthalmological examination at a tertiary care hospital in the Republic of Korea from 2006 to 2018 were enrolled.
There was a total of 152 adult candidemia patients analyzed. EFE was found in 29 patients (19.1%). Patients were categorized into two groups (Non-endophthalmitis [NE] and endophthalmitis [E]). Between the two groups, there was no significant difference in terms of age, sex, and underlying comorbidities. However, there were more Candida albicans candidemia, abnormal alanine aminotransferase (ALT) at the time of candidemia diagnosis, receipt of antifungal treatment≥48hours after onset of candidemia symptoms and blood culture sample (AOCS), and candidemia clearance≥5days after initiation of antifungal treatment (AIAT) in the E group. A predictive model for the E was created, which had an area of 0.811 under the receiver operating characteristics curve. In a multivariate logistic regression analysis, C. albicans candidemia, ALT at the time of candidemia diagnosis, receipt of antifungal treatment≥48hours AOCS, and candidemia clearance≥5days AIAT were significantly associated with EFE.
EFE occurred in 19% of adult patients with candidemia. Adult candidemia patients with C. albicans candidemia, abnormal ALT, receipt of antifungal treatment≥48hours AOCS, and candidemia clearance≥5days AIAT need to be closely monitored for the possibility of EFE.
内源性真菌性眼内炎（EFE）是念珠菌血症的严重并发症。我们进行了一项研究，以调查 EFE 的患病率和危险因素。
我们纳入了 2006 年至 2018 年期间在韩国一家三级保健医院接受眼科检查的成年念珠菌血症患者。
共分析了 152 例成年念珠菌血症患者。在 29 例患者（19.1%）中发现 EFE。将患者分为两组（非眼内炎组[NE]和眼内炎组[E]）。两组之间，年龄、性别和基础合并症无显著差异。然而，E 组中更常见白色念珠菌念珠菌血症、念珠菌血症诊断时丙氨酸氨基转移酶（ALT）异常、抗真菌治疗开始≥48 小时后发生念珠菌血症症状和血培养样本（AOCS）以及抗真菌治疗开始后≥5 天清除念珠菌血症（AIAT）。建立了 E 的预测模型，其在受试者工作特征曲线下的面积为 0.811。多变量逻辑回归分析显示，白色念珠菌念珠菌血症、念珠菌血症诊断时的 ALT、抗真菌治疗开始≥48 小时 AOCS 和抗真菌治疗开始后≥5 天清除念珠菌血症与 EFE 显著相关。
成人念珠菌血症患者中 EFE 的发生率为 19%。患有白色念珠菌血症、ALT 异常、抗真菌治疗开始≥48 小时 AOCS 和抗真菌治疗开始后≥5 天清除念珠菌血症的成人念珠菌血症患者需要密切监测 EFE 的可能性。
