Laboratory of Clinical Pathology and Blood Bank, Mahar Mardjono National Brain Center Hospital, East Jakarta, Indonesia.
Department of Clinical Pathology, Faculty of Medicine University of Indonesia/Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
J Infect Dev Ctries. 2022 May 30;16(5):871-880. doi: 10.3855/jidc.15231.
Invasive candidiasis is a severe form of infection. The incidence of invasive fungal infections has increased, due to the increasing number of patients with impaired immunity who are being treated through prolonged stay in hospital facilities. Neurological patient treatment methods such as antimicrobials, corticosteroid, central venous catheter (CVC), total parenteral nutrition, and mechanical ventilation use are associated with common risk factors for invasive candidiasis. Our study demonstrated invasive candidiasis prevalence among neurological patients.
A cross-sectional study was done with consecutive sampling of neurological patients who were hospitalized from January 2017 to February 2020 at the Mahar Mardjono National Brain Center Hospital East Jakarta Indonesia. Patients with sepsis, septic shock, or fever (> 38.5 °C), and who had not received antifungals before culture were enrolled in the study. Clinical specimens were obtained from blood, liquor cerebrospinal or other sterile sites, CVC, respiratory tract specimens, and urine or other non-sterile sites. Socio-demographic data, potential risk factors based on previous studies, clinical, and other tests data were obtained from medical records. Classification of invasive candidiasis was according to the Paphitou classification criteria.
One hundred and two subjects met the study criteria. The prevalence of invasive candidiasis in neurological patients was 13.7%. All of the isolates were C. parapsilosis.
The prevalence of invasive candidiasis was high in the samples studied. The infection was associated with septic shock, tracheostomy, and duration of use of central venous catheter, ventilator, and steroids.
侵袭性念珠菌病是一种严重的感染形式。由于接受长期住院治疗的免疫功能受损患者数量增加，侵袭性真菌感染的发病率有所增加。抗菌药物、皮质类固醇、中央静脉导管 (CVC)、全胃肠外营养和机械通气等神经科患者的治疗方法与侵袭性念珠菌病的常见危险因素有关。我们的研究表明神经科患者中存在侵袭性念珠菌病。
本研究采用连续抽样法，对 2017 年 1 月至 2020 年 2 月期间在印度尼西亚雅加达东玛哈马里恩德国家脑中心医院住院的神经科患者进行了横断面研究。纳入标准为患有败血症、感染性休克或发热（>38.5°C），且在培养前未接受抗真菌药物治疗的患者。从血液、脑脊液或其他无菌部位、CVC、呼吸道标本、尿液或其他非无菌部位采集临床标本。从病历中获取社会人口统计学数据、基于既往研究的潜在危险因素、临床和其他检查数据。侵袭性念珠菌病的分类依据 Paphitou 分类标准。
102 名患者符合研究标准。神经科患者侵袭性念珠菌病的患病率为 13.7%。所有分离株均为近平滑念珠菌。
在所研究的样本中，侵袭性念珠菌病的患病率较高。感染与感染性休克、气管切开术以及中央静脉导管、呼吸机和类固醇的使用时间有关。
