Ramos-Martínez Antonio, Pintos-Pascual Ilduara, Guinea Jesús, Gutiérrez-Villanueva Andrea, Gutiérrez-Abreu Edith, Díaz-García Judith, Asensio Ángel, Iranzo Reyes, Sánchez-Romero Isabel, Muñoz-Algarra María, Moreno-Torres Víctor, Calderón-Parra Jorge, Múñez Elena, Fernández-Cruz Ana
Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Hospital Universitario Puerta de Hierro, 28222 Majadahonda, Spain.
Instituto de Investigación Sanitaria Puerta de Hierro-Segovia de Arana (IDIPHSA), 28222 Majadahonda, Spain.
J Fungi (Basel). 2022 Apr 27;8(5):451. doi: 10.3390/jof8050451.
Severely ill COVID-19 patients are at high risk of nosocomial infections. The aim of the study was to describe the characteristics of candidemia during the pre-pandemic period (January 2019−February 2020) compared to the pandemic period (March 2020−September 2021). Antifungal susceptibilities were assessed using the EUCAST E.Def 7.3.2 broth dilution method. Fluconazole-resistant C. parapsilosis isolates (FRCP) were studied for sequencing of the ERG11 gene. The incidence of candidemia and C. parapsilosis bloodstream infection increased significantly in the pandemic period (p = 0.021). ICU admission, mechanical ventilation, parenteral nutrition and corticosteroids administration were more frequent in patients with candidemia who had been admitted due to COVID-19. Fifteen cases of FRCP fungemia were detected. The first case was recorded 10 months before the pandemic in a patient transferred from another hospital. The incidence of FRCP in patients admitted for COVID-19 was 1.34 and 0.16 in all other patients (p < 0.001). ICU admission, previous Candida spp. colonization, arterial catheter use, parenteral nutrition and renal function replacement therapy were more frequent in patients with candidemia due to FRCP. All FRCP isolates showed the Y132F mutation. In conclusion, the incidence of candidemia experienced an increase during the COVID-19 pandemic and FRCP fungemia was more frequent in patients admitted due to COVID-19.
重症新冠病毒肺炎患者发生医院感染的风险很高。本研究旨在描述大流行前时期（2019年1月至2020年2月）与大流行时期（2020年3月至2021年9月）念珠菌血症的特征。采用欧盟CAST E.Def 7.3.2肉汤稀释法评估抗真菌药敏性。对氟康唑耐药的近平滑念珠菌分离株（FRCP）进行ERG11基因测序研究。大流行期间念珠菌血症和近平滑念珠菌血流感染的发生率显著增加（p = 0.021）。因新冠病毒肺炎入院的念珠菌血症患者更频繁地入住重症监护病房（ICU）、接受机械通气、肠外营养和使用糖皮质激素。检测到15例FRCP真菌血症病例。首例病例在大流行前10个月记录于一名从另一家医院转来的患者。因新冠病毒肺炎入院患者的FRCP发生率为1.34，其他所有患者为0.16（p < 0.001）。因FRCP导致念珠菌血症的患者更频繁地入住ICU、既往有念珠菌属定植、使用动脉导管、接受肠外营养和肾功能替代治疗。所有FRCP分离株均显示Y132F突变。总之，新冠病毒肺炎大流行期间念珠菌血症的发生率有所增加，且因新冠病毒肺炎入院的患者中FRCP真菌血症更为常见。
