Blaize Marion, Raoelina Audrey, Kornblum Dimitri, Kamus Laure, Lampros Alexandre, Berger Marie, Demeret Sophie, Constantin Jean-Michel, Monsel Antoine, Mayaux Julien, Luyt Charles-Edouard, Piarroux Renaud, Fekkar Arnaud
Sorbonne Université, INSERM, CNRS, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Parasitologie Mycologie, F-75013 Paris, France.
Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier La Pitié-Salpêtrière, Parasitologie Mycologie, F-75013 Paris, France.
J Fungi (Basel). 2022 Jun 28;8(7):678. doi: 10.3390/jof8070678.
Whether severe COVID-19 is by itself a significant risk factor for the development of candidemia currently remains an open question as conflicting results have been published. We aim to assess the occurrence of candidemia in patients with severe COVID-19 admitted to the intensive care unit (ICU). We conducted a retrospective study on patients with severe SARS-CoV-2-related pneumonia admitted to 5 ICUs in France who were specifically screened for fungal complications between March 2020 and January 2021. The study population included a total of 264 patients; the median age was 56 years old and most of them were male (n = 186; 70.5%) and immunocompetent (n = 225; 87.5%), and 62.7% (n = 153/244) were on extracorporeal membrane oxygenation support. Microbiological analysis included 4864 blood culture samples and beta-glucan test performed on 975 sera. Candidemia was diagnosed in 13 (4.9%) patients. The species involved were mainly (n = 6) and (n = 5). Almost all patients (12/13; 92.3%) had a colonization by yeasts. ICU mortality was not significantly impacted by the occurrence of candidemia. Unrelated positive beta-glucan tests were observed in 49 patients (23.4%), including 6 with mold infections and 43 with false positive results. In our series, patients with severe SARS-CoV-2-related pneumonia seemed at low risk of developing invasive candidiasis.
目前,重症新冠病毒疾病本身是否是念珠菌血症发生的一个重要风险因素仍是一个悬而未决的问题,因为已发表的研究结果相互矛盾。我们旨在评估入住重症监护病房(ICU)的重症新冠病毒疾病患者中念珠菌血症的发生率。我们对2020年3月至2021年1月期间入住法国5家ICU的重症严重急性呼吸综合征冠状病毒2(SARS-CoV-2)相关肺炎患者进行了一项回顾性研究,这些患者专门接受了真菌并发症筛查。研究人群共包括264例患者;中位年龄为56岁,其中大多数为男性(n = 186;70.5%)且免疫功能正常(n = 225;87.5%),62.7%(n = 153/244)接受体外膜肺氧合支持。微生物学分析包括4864份血培养样本以及对975份血清进行的β-葡聚糖检测。13例(4.9%)患者被诊断为念珠菌血症。涉及的菌种主要为 (n = 6)和 (n = 5)。几乎所有患者(12/13;92.3%)都有酵母菌定植。念珠菌血症的发生对ICU死亡率没有显著影响。49例患者(23.4%)观察到不相关的β-葡聚糖检测阳性,其中6例为霉菌感染,43例为假阳性结果。在我们的系列研究中,重症SARS-CoV-2相关肺炎患者发生侵袭性念珠菌病的风险似乎较低。