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黎巴嫩一家三级护理中心对念珠菌血症进行的为期16年的研究中,光滑念珠菌在非念珠菌属菌种中占主导地位。

Predominance of Candida Glabrata among Non- Candida Species in a 16-Year Study of Candidemia at a Tertiary Care Center in Lebanon.

作者信息

Zakhem Aline El, Istambouli Rachid, Alkozah Maria, Gharamti Amal, Tfaily Mohamad Ali, Jabbour Jean-Francois, Araj George F, Tamim Hani, Kanj Souha S

机构信息

Department of Internal Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon.

Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon.

出版信息

Pathogens. 2021 Jan 19;10(1):82. doi: 10.3390/pathogens10010082.

Abstract

Candidemia is associated with a high mortality rate, and its incidence is increasing worldwide with a rise in non- candidemia (NAC). Epidemiologic data from Arab countries are scarce and there are no data from Lebanon; Methods: This is a single-center retrospective chart review of patients with candidemia in a tertiary care center in Lebanon from 2004 to 2019. We extracted data on patient characteristics, isolated species antifungal susceptibility, management and outcomes; Results: We included 170 cases of candidemia. NAC was more common than candidemia (64.7% vs. 35.3%). was the most common non- species (37 isolates) followed by (14). Recent use of antifungals was a risk factor for NAC (OR = 2.8, = 0.01), while the presence of a central venous catheter was protective (OR = 0.41, = 0.02). Fluconazole resistance was 12.5% in and 21.5% in non- spp. Mortality at 30 days was 55.5%, with no difference between NAC and candidemia. It was higher in older and critically ill patients but lower in patients whose central venous catheter was removed after detecting fungemia; Conclusions: Candidemia is associated with high mortality in Lebanon, with a predominance of NAC and high prevalence of .

摘要

念珠菌血症与高死亡率相关,并且随着非念珠菌血症(NAC)的增加,其在全球的发病率也在上升。来自阿拉伯国家的流行病学数据稀缺,黎巴嫩尚无相关数据;方法:这是一项对黎巴嫩一家三级护理中心2004年至2019年念珠菌血症患者的单中心回顾性病历审查。我们提取了患者特征、分离菌种的抗真菌药敏性、治疗及转归的数据;结果:我们纳入了170例念珠菌血症病例。NAC比念珠菌血症更常见(64.7%对35.3%)。 是最常见的非 菌种(37株分离株),其次是 (14株)。近期使用抗真菌药物是NAC的一个危险因素(OR = 2.8, = 0.01),而中心静脉导管的存在具有保护作用(OR = 0.41, = 0.02)。白色念珠菌的氟康唑耐药率为12.5%,非白色念珠菌属为21.5%。30天死亡率为55.5%,NAC和念珠菌血症之间无差异。在老年和重症患者中死亡率较高,但在真菌血症检测后拔除中心静脉导管的患者中死亡率较低;结论:在黎巴嫩,念珠菌血症与高死亡率相关,NAC占主导且 感染率高。

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