南非一家医院的耳念珠菌（Candida auris）培养患者与其他念珠菌患者的临床和实验室特征比较。

Clinical and laboratory features of patients with Candida auris cultures, compared to other Candida, at a South African Hospital.

机构信息

Department of Internal Medicine, University of the Witwatersrand Johannesburg, South Africa.

Division of Infectious Diseases, Department of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, University of the Witwatersrand, South Africa.

出版信息

J Infect Dev Ctries. 2022 Jan 31;16(1):213-221. doi: 10.3855/jidc.14917.

DOI:10.3855/jidc.14917

PMID:35192540

Abstract

INTRODUCTION

Multidrug resistant Candida auris is an emerging threat worldwide. It has been identified in Africa, however, there is minimal data available comparing C. auris to other Candida species in Africa.

METHODOLOGY

Retrospective, case control study at a tertiary South African Hospital. Clinical and laboratory features of patients with positive C. auris clinical cultures from 1 January 2015 to 31 August 2018 were compared to patients who cultured C. albicans and C. glabrata.

RESULTS

Forty-five clinical cases with C. auris cultures were identified. The median age was 32 years (IQR = 26-46). The median duration of hospital stay was 64 days (IQR = 39-88) and median time from admission to diagnosis 35 days (IQR = 21-53). Indwelling devices and previous antibiotic exposure were found to be significant risk factors. All C. auris isolates were susceptible to amphotericin B and micafungin. Patients treated with amphotericin B alone, had a higher mortality (73.33%, n = 11/15) than patients treated with an echinocandin (54.55%, n = 6/11), however this was not statistically significant. All C. auris isolates were healthcare associated with 80% (n = 36/45) acquired in ICU. The 30-day all-cause in-patient mortality was 42% (n = 19/45) for C. auris, 36% (n = 16/45) for C. albicans and 53% (n = 24/45) for C. glabrata.

CONCLUSIONS

C. auris is an emerging multi drug resistant threat in South Africa. Improved access to echinocandins and improvement of infection prevention and control strategies are imperative to prevent further morbidity and mortality due to this pathogen.

摘要

简介

多药耐药性假丝酵母菌是一种正在全球范围内出现的威胁。它已经在非洲被发现，然而，关于非洲的假丝酵母菌属中其他种与假丝酵母菌属的比较，可用的数据很少。

方法

在南非一家三级医院进行的回顾性病例对照研究。对 2015 年 1 月 1 日至 2018 年 8 月 31 日期间阳性假丝酵母菌属临床培养物的患者的临床和实验室特征与培养出白色假丝酵母菌和光滑假丝酵母菌的患者进行了比较。

结果

共鉴定出 45 例假丝酵母菌属培养阳性的临床病例。中位年龄为 32 岁（IQR = 26-46）。中位住院时间为 64 天（IQR = 39-88），从入院到诊断的中位时间为 35 天（IQR = 21-53）。留置装置和先前的抗生素暴露被认为是显著的危险因素。所有假丝酵母菌属的分离株均对两性霉素 B 和米卡芬净敏感。单独使用两性霉素 B 治疗的患者死亡率（73.33%，n = 11/15）高于使用棘白菌素治疗的患者（54.55%，n = 6/11），但无统计学意义。所有假丝酵母菌属的分离株均与医疗保健相关，80%（n = 36/45）是在 ICU 获得的。假丝酵母菌属的 30 天全因住院死亡率为 42%（n = 19/45），白色假丝酵母菌属为 36%（n = 16/45），光滑假丝酵母菌属为 53%（n = 24/45）。