Maimonides Medical Center, Brooklyn, New York, USA.
The Brooklyn Hospital Center, Brooklyn, New York, USA.
Clin Infect Dis. 2023 Feb 8;76(3):e1436-e1443. doi: 10.1093/cid/ciac735.
This study was performed to compare clinical characteristics and outcomes between patients with bloodstream infections (BSIs) caused by Candida auris and those with BSIs caused by other Candida spp.
A multicenter retrospective case-control study was performed at 3 hospitals in Brooklyn, New York, between 2016 and 2020. The analysis included patients ≥18 years of age who had a positive blood culture for any Candida spp. and were treated empirically with an echinocandin. The primary outcome was the 30-day mortality rate. Secondary outcomes were 14-day clinical failure, 90-day mortality rate, 60-day microbiologic recurrence, and in-hospital mortality rate.
A total of 196 patients were included in the final analysis, including 83 patients with candidemia caused by C. auris. After inverse propensity adjustment, C. auris BSI was not associated with increased 30-day (adjusted odds ratio, 1.014 [95% confidence interval, .563-1.828]); P = .96) or 90-day (0.863 [.478-1.558]; P = .62) mortality rates. A higher risk for microbiologic recurrence within 60 days of completion of antifungal therapy was observed in patients with C. auris candidemia (adjusted odds ratio, 4.461 [95% confidence interval, 1.033-19.263]; P = .045).
C. auris BSIs are not associated with a higher mortality risk than BSIs caused by other Candida spp. The rate of microbiologic recurrence was higher in the C. auris group.
本研究旨在比较由耳念珠菌引起的血流感染(BSI)患者与由其他念珠菌引起的 BSI 患者的临床特征和结局。
这是一项在纽约布鲁克林的 3 家医院进行的多中心回顾性病例对照研究,时间为 2016 年至 2020 年。分析纳入了≥18 岁、血培养阳性的任何念珠菌属患者,这些患者接受了经验性棘白菌素治疗。主要结局为 30 天死亡率。次要结局为 14 天临床失败率、90 天死亡率、60 天微生物学复发率和住院死亡率。
共有 196 例患者纳入最终分析,其中 83 例为耳念珠菌引起的念珠菌血症。经反向倾向评分调整后,耳念珠菌 BSI 与 30 天(调整后的优势比,1.014 [95%置信区间,.563-1.828];P =.96)或 90 天(0.863 [.478-1.558];P =.62)死亡率增加无关。与其他念珠菌引起的 BSI 相比,完成抗真菌治疗后 60 天内微生物学复发的风险更高(调整后的优势比,4.461 [95%置信区间,1.033-19.263];P =.045)。
与由其他念珠菌引起的 BSI 相比,耳念珠菌 BSI 与更高的死亡率风险无关。耳念珠菌组的微生物学复发率更高。