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哥伦比亚麦德林市一家高复杂性医院确诊的真菌血症患者的眼科并发症风险因素和眼部表现。

Risk factors for ophthalmologic involvement and ocular findings in patients diagnosed with fungemia in a high-complexity hospital in the city of Medellín, Colombia.

机构信息

Ophthalmology program, School of Health Sciences, School of Medicine, Universidad Pontificia Bolivariana, Medellín, Colombia.

Ophthalmology Department, Hospital Pablo Tobón Uribe, Medellín, Colombia.

出版信息

Ann Med. 2022 Dec;54(1):2204-2210. doi: 10.1080/07853890.2022.2107700.

Abstract

PURPOSE

To describe the demographic clinical characteristics and to identify the risk factors of patients diagnosed with fungemia and secondary intraocular involvement.

METHODS

Retrospective cohort of 97 patients diagnosed with fungemia and with or without involvement of the posterior segment. Demographic, clinical and ophthalmological variables were identified to establish the risk of retinal seeding.

RESULTS

An incidence of ocular involvement of 22.68% was obtained and no clear risk factor was found for subsequent showings in patients with fungemia. A risk trend was only found in patients with diabetes with an OR: 2.85; CI 95%: (0.80-10.12) and history of HIV with an OR: 2.29 CI95%: (0.85-6.12).

CONCLUSIONS

In this first cohort carried out in Colombia according to our search, findings were obtained that agree with those of other authors worldwide, where there is no evidence of a decrease in incidence compared with older studies and the absence of risk factors for the compromise of the posterior pole in patients with fungemia.KEY MESSAGESSystematic fundus evaluation by an ophthalmologist in patients with candidaemia is a recommended practice based on low-quality evidence.The identification of real risk factors for retinal compromise in fungemia would allow us to be more selective with the population to be evaluated.Fungemia generally occurs in critically ill patients, where access and availability of ophthalmology evaluation are a resource that is not always available.

摘要

目的

描述患有真菌血症和继发性眼内感染患者的人口统计学临床特征,并确定其危险因素。

方法

对 97 例诊断为真菌血症且有或无后段受累的患者进行回顾性队列研究。确定了人口统计学、临床和眼科变量,以确定视网膜播散的风险。

结果

获得了眼内受累的发生率为 22.68%,但未发现真菌血症患者后续表现的明确危险因素。仅在糖尿病患者中发现了风险趋势,OR:2.85;95%CI:(0.80-10.12)和 HIV 病史患者,OR:2.29;95%CI:(0.85-6.12)。

结论

根据我们的搜索,在哥伦比亚进行的这项首次队列研究中得出了与世界其他作者一致的发现,与较旧的研究相比,没有证据表明发病率下降,并且真菌血症患者后极受累没有危险因素。

关键信息

基于低质量证据,建议对患有念珠菌血症的患者进行眼科医生系统的眼底评估。

确定真菌血症中视网膜损伤的真正危险因素将使我们能够更有选择性地评估人群。

真菌血症通常发生在重症患者中,而获得和提供眼科评估的机会并不是总是存在的资源。

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Microbiological diagnosis of bacteraemia and fungaemia: Blood cultures and molecular methods.菌血症和真菌血症的微生物学诊断:血培养和分子方法。
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