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念珠菌血症的流行病学:来自克罗地亚一家三级护理医院的三年结果

Epidemiology of Candidemia: Three-Year Results from a Croatian Tertiary Care Hospital.

作者信息

Mareković Ivana, Pleško Sanja, Rezo Vranješ Violeta, Herljević Zoran, Kuliš Tomislav, Jandrlić Marija

机构信息

University Hospital Centre Zagreb, Department of Clinical and Molecular Microbiology,School of Medicine, University of Zagreb, Zagreb 10 000, Croatia.

University Hospital Centre Zagreb, Department of Urology, School of Medicine, University of Zagreb, Zagreb 10 000, Croatia.

出版信息

J Fungi (Basel). 2021 Mar 31;7(4):267. doi: 10.3390/jof7040267.

Abstract

Invasive candidosis is the most common invasive fungal infection in hospitalized patients and is associated with a high mortality rate. This is the first study from a Croatian tertiary care hospital describing epidemiology, risk factors and species distribution in patients with candidemia. A three-year retrospective observational study, from 2018 to 2020, was performed at the University Hospital Centre Zagreb, Zagreb, Croatia. A total of 160 patients with candidemia ( = 170 isolates) were enrolled. Candidemia incidence increased from 0.47 to 0.69 per 1000 admissions in 2018 and 2020, respectively. Ninety-five patients (58.38%) were in the intensive care unit. The main risk factors for candidemia were central venous catheter (CVC) (84.38%), previous surgical procedure (56.88%) and invasive mechanical ventilation (42.50%) was identified in 43.53% of isolates, followed by (31.76%) and (12.36%), (5.29%), (2.35%) and (2.35%). The study discovered a shift to non- species, particularly , and made it possible to determine the main tasks we should focus on to prevent candidemia in the hospital, these being mainly infection control measures directed towards prevention of catheter-related bloodstream infections, specifically comprising hand hygiene and CVC bundles of care. The potential benefit of fluconazole prophylaxis in certain populations of surgical patients could also be considered.

摘要

侵袭性念珠菌病是住院患者中最常见的侵袭性真菌感染,且死亡率很高。这是克罗地亚一家三级护理医院首次开展的关于念珠菌血症患者的流行病学、危险因素及菌种分布的研究。2018年至2020年期间,在克罗地亚萨格勒布大学医院中心进行了一项为期三年的回顾性观察研究。共纳入160例念珠菌血症患者(分离出170株菌株)。念珠菌血症发病率在2018年和2020年分别从每1000例入院患者中的0.47例增至0.69例。95例患者(58.38%)在重症监护病房。念珠菌血症的主要危险因素为中心静脉导管(CVC)(84.38%)、既往手术操作(56.88%)和有创机械通气(42.50%);在43.53%的分离菌株中鉴定出,其次是(31.76%)和(12.36%)、(5.29%)、(2.35%)和(2.35%)。该研究发现念珠菌血症已转向非菌种,尤其是,并且确定了我们在医院预防念珠菌血症应重点关注的主要任务,这些任务主要是针对预防导管相关血流感染的感染控制措施,具体包括手卫生和CVC护理集束。还可考虑在某些手术患者群体中预防性使用氟康唑的潜在益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5cfa/8065499/27abb03d70e3/jof-07-00267-g001.jpg

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