Kim Si-Ho, Mun Seok Jun, Kang Jin Suk, Moon Chisook, Kim Hyoung-Tae, Lee Ho Young
Division of Infectious Diseases, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon 51353, Republic of Korea.
Division of Infectious Diseases, Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea.
J Fungi (Basel). 2023 Feb 18;9(2):270. doi: 10.3390/jof9020270.
We aimed to evaluate various aspects of antibiotic therapy as factors associated with candidemia in non-neutropenic patients. A retrospective, matched, case-control study was conducted in two teaching hospitals. Patients with candidemia (cases) were compared to patients without candidemia (controls), matched by age, intensive care unit admission, duration of hospitalization, and type of surgery. Logistic regression analyses were performed to identify factors associated with candidemia. A total of 246 patients were included in the study. Of 123 candidemia patients, 36% had catheter-related bloodstream infections (CRBSIs). Independent factors in the whole population included immunosuppression (adjusted odds ratio [aOR] = 2.195; = 0.036), total parenteral nutrition (aOR = 3.642; < 0.001), and anti-methicillin-resistant (MRSA) therapy for ≥11 days (aOR = 5.151; = 0.004). The antibiotic factor in the non-CRBSI population was anti-pseudomonal beta-lactam treatment duration of ≥3 days (aOR = 5.260; = 0.008). The antibiotic factors in the CRBSI population included anti-MRSA therapy for ≥11 days (aOR = 10.031; = 0.019). Antimicrobial stewardship that reduces exposure to these antibacterial spectra could help prevent the development of candidemia.
我们旨在评估抗生素治疗的各个方面，作为非中性粒细胞减少患者念珠菌血症的相关因素。在两家教学医院进行了一项回顾性、匹配的病例对照研究。将念珠菌血症患者（病例组）与无念珠菌血症患者（对照组）进行比较，根据年龄、重症监护病房入住情况、住院时间和手术类型进行匹配。进行逻辑回归分析以确定与念珠菌血症相关的因素。共有246名患者纳入研究。在123例念珠菌血症患者中，36%患有导管相关血流感染（CRBSIs）。总体人群中的独立因素包括免疫抑制（调整后的优势比[aOR]=2.195；P=0.036）、全胃肠外营养（aOR=3.642；P<0.001）以及抗耐甲氧西林金黄色葡萄球菌（MRSA）治疗≥11天（aOR=5.151；P=0.004）。非CRBSI人群中的抗生素因素是抗假单胞菌β-内酰胺治疗持续时间≥3天（aOR=5.260；P=0.008）。CRBSI人群中的抗生素因素包括抗MRSA治疗≥11天（aOR=10.031；P=0.019）。减少接触这些抗菌谱的抗菌药物管理有助于预防念珠菌血症的发生。
