Al-Musawi Tariq S, Alkhalifa Wala A, Alasaker Norah A, Rahman Jawad U, Alnimr Amani M
Department of Internal Medicine, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA.
Department of Medical Microbiology, King Fahad Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, KSA.
J Taibah Univ Med Sci. 2020 Dec 30;16(2):184-190. doi: 10.1016/j.jtumed.2020.12.002. eCollection 2021 Apr.
Candidemia incidence has increased in the past few years, with high mortality. Previous studies have reported a variable distribution of spp. among different regions. This study aimed to identify the species found in bloodstream infections, routine antifungal susceptibility testing, and mortality outcomes in an academic medical centre.
Between January 2012 and December 2018, the positive blood cultures for candidemia infection were retrieved and statistically analysed for species prevalence, susceptibility pattern, and crude mortality at 14, 30, 60 and 90 days.
Of 156 candidemia cases, a majority (69.2%) was caused by non-albicans spp. After (30.8%), and were the second and third most frequeunt isolates spp, each counting for 23.7%. Acquired resistance was detected in 14.8% of candidemia strains. No other antifungal resistance was detected. The overall crude mortality rates of all species were 29.3%, 47.9%, 56.4%, and 58.0% at 14, 30, 60, and 90 days, respectively. A higher mortality rate was noted in cases of infection (crude mortality 71.4-100%, = 0.002).
In this study, a considerable shift to non-albicans causing most bloodstream infections was observed. As such infections pose a serious threat to hospitalised patients, microbiology laboratories are urged to adopt rapid diagnostic and minimal inhibitory concentration-based testing for the detection of susceptible dose-dependent phenotypes. Prospective studies are essential to consider the prognosis of bloodstream infections by various species in a multivariate model.
念珠菌血症的发病率在过去几年有所上升，死亡率很高。先前的研究报告了不同地区念珠菌属的分布情况各不相同。本研究旨在确定在一所学术医疗中心的血流感染中发现的菌种、常规抗真菌药敏试验以及死亡结局。
在2012年1月至2018年12月期间，检索念珠菌血症感染的阳性血培养物，并对菌种流行率、药敏模式以及14天、30天、60天和90天的粗死亡率进行统计分析。
在156例念珠菌血症病例中，大多数（69.2%）由非白色念珠菌属引起。在白色念珠菌（30.8%）之后，热带念珠菌和光滑念珠菌是第二和第三常见的分离菌种，各占23.7%。在14.8%的念珠菌血症菌株中检测到获得性耐药。未检测到其他抗真菌耐药性。所有菌种的总体粗死亡率在14天、30天、60天和90天时分别为29.3%、47.9%、56.4%和58.0%。热带念珠菌感染病例的死亡率较高（粗死亡率71.4 - 100%，P = 0.002）。
在本研究中，观察到引起大多数血流感染的菌种已显著转向非白色念珠菌属。由于此类感染对住院患者构成严重威胁，敦促微生物实验室采用快速诊断和基于最低抑菌浓度的检测方法来检测敏感的剂量依赖性表型。前瞻性研究对于在多变量模型中考虑各种念珠菌属引起的血流感染的预后至关重要。
