Machado Marina, Estévez Agustín, Sánchez-Carrillo Carlos, Guinea Jesús, Escribano Pilar, Alonso Roberto, Valerio Maricela, Padilla Belén, Bouza Emilio, Muñoz Patricia
Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain.
Instituto de Investigación Sanitaria Gregorio Marañón, 28007 Madrid, Spain.
J Fungi (Basel). 2022 Mar 16;8(3):305. doi: 10.3390/jof8030305.
There is scarce information on the actual incidence of candidemia in COVID-19 patients. In addition, comparative studies of candidemia episodes in COVID-19 and non-COVID-19 patients are heterogeneous. Here, we assessed the real incidence, epidemiology, and etiology of candidemia in COVID-19 patients, and compared them with those without COVID-19 (2020 vs. 2019 and 2020, respectively). We also genotyped all , , and isolates ( = 88), causing candidemia in both groups, providing for the first time a genotypic characterization of isolates gathered in patients with either COVID-19 or non-COVID-19. Incidence of candidemia was higher in patients with COVID-19 than non-COVID-19 (4.73 vs. 0.85 per 1000 admissions; 3.22 vs. 1.14 per 10,000 days of stay). No substantial intergroup differences were found, including mortality. Genotyping proved the presence of a low number of patients involved in clusters, allowing us to rule out rampant patient-to-patient transmission. The four patients, involved in two clusters, had catheter-related candidemia diagnosed in the first COVID-19 wave, which demonstrates breaches in catheter management policies occurring in such an overwhelming situation. In conclusion, the incidence of candidemia in patients with COVID-19 is significantly higher than in those without COVID-19. However, genotyping shows that this increase is not due to uncontrolled intrahospital transmission.
关于新冠病毒病（COVID-19）患者念珠菌血症的实际发病率，目前信息匮乏。此外，针对COVID-19患者与非COVID-19患者念珠菌血症发作情况的比较研究也存在异质性。在此，我们评估了COVID-19患者念珠菌血症的实际发病率、流行病学特征及病因，并分别与非COVID-19患者（分别为2020年与2019年及2020年对比）进行比较。我们还对两组中所有引起念珠菌血症的白色念珠菌、光滑念珠菌和热带念珠菌分离株（n = 88）进行了基因分型，首次提供了COVID-19患者或非COVID-19患者中分离株的基因特征。COVID-19患者念珠菌血症的发病率高于非COVID-19患者（每1000例入院患者中分别为4.73例和0.85例；每10000住院日中分别为3.22例和1.14例）。未发现包括死亡率在内的显著组间差异。基因分型证明涉及聚集性感染的患者数量较少，这使我们能够排除患者之间的猖獗传播。在第一波COVID-19疫情中，有4名患者参与了两个聚集性感染事件，被诊断为导管相关念珠菌血症，这表明在这种压倒性的情况下，导管管理政策存在漏洞。总之，COVID-19患者念珠菌血症的发病率显著高于非COVID-19患者。然而，基因分型表明这种增加并非由于医院内传播失控所致。
