南非一家三级医院念珠菌血症的发病率及唑类耐药念珠菌血症的患病率——一项2016 - 2020年的回顾性实验室分析

Incidence of candidemia and prevalence of azole-resistant candidemia at a tertiary South African hospital - A retrospective laboratory analysis 2016-2020.

作者信息

Chibabhai Vindana

机构信息

Department of Clinical Microbiology and Infectious Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Clinical Microbiology Laboratory, Charlotte Maxeke Johannesburg Academic Hospital, National Health Laboratory Service, Johannesburg, South Africa.

出版信息

S Afr J Infect Dis. 2022 Feb 15;37(1):326. doi: 10.4102/sajid.v37i1.326. eCollection 2022.

DOI:10.4102/sajid.v37i1.326

PMID:35284564

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8905471/

Abstract

BACKGROUND

Candidemia is associated with high morbidity and mortality. The epidemiology of candidemia has changed globally over the past 20 years. South African surveillance demonstrated a shift in epidemiology from to non-albicans species including and . Hospital-level candidemia incidence from South Africa has not been reported previously.

METHODS

We performed a retrospective laboratory-based analysis of blood cultures with confirmed causative agents of candidemia. Ward type, department, gender and admission to critical care units were captured. Data were analysed in Microsoft Excel, Statistical Package for the Social Sciences (SPSS) and Epitools.

RESULTS

The incidence of candidemia during the study period was 2.87 per 1000 admissions. The total proportion of non-albicans species causing candidemia was 425/618 (69.7%). Overall, 65.4% of candidemia cases occurred in non-critical care units. There was a significant increase in the proportion of isolates between 2016 and 2020 ( < 0.001). Isolation of was associated with admission to critical care units ( < 0.001, odds ration [OR] 3.856, 95% confidence interval [CI]: 2.360-6.300). The proportion of azole-resistant candidemia cases increased from 21/53 (39.6%) in 2016 to 41/59 (69.5%) in 2020 ( = 0.002).

CONCLUSION

The incidence of candidemia remained stable over the five-year study period. However, the proportion of isolates increased significantly during the study period as did the overall proportion of azole-resistant candidemia. Antifungal stewardship and continued hospital-level surveillance are imperative.

摘要

背景

念珠菌血症与高发病率和死亡率相关。在过去20年里，全球念珠菌血症的流行病学情况发生了变化。南非的监测表明，其流行病学已从转变为非白色念珠菌属，包括和。此前尚未报道过南非医院层面的念珠菌血症发病率。

方法

我们对确诊为念珠菌血症病原体的血培养进行了基于实验室的回顾性分析。记录了病房类型、科室、性别以及入住重症监护病房的情况。数据在Microsoft Excel、社会科学统计软件包（SPSS）和Epitools中进行分析。

结果

研究期间念珠菌血症的发病率为每1000例入院患者中有2.87例。引起念珠菌血症的非白色念珠菌属的总比例为425/618（69.7%）。总体而言，65.4%的念珠菌血症病例发生在非重症监护病房。2016年至2020年期间，分离株的比例显著增加（<0.001）。的分离与入住重症监护病房相关（<0.001，优势比[OR]为3.856，95%置信区间[CI]：2.360 - 6.300）。唑类耐药念珠菌血症病例的比例从2016年的21/53（39.6%）增加到2020年的41/59（69.5%）（=0.002）。