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从黎巴嫩医院的各种临床标本中分离的非白色念珠菌的特征和敏感性。

Characterization and susceptibility of non-albicans isolated from various clinical specimens in Lebanese hospitals.

机构信息

Lebanese American University, School of Medicine, Beirut, Lebanon.

Department of Internal Medicine, Lebanese American University-Rizk Hospital, Beirut, Lebanon.

出版信息

Front Public Health. 2023 Mar 10;11:1115055. doi: 10.3389/fpubh.2023.1115055. eCollection 2023.

Abstract

BACKGROUND

Invasive fungal infections have presented a challenge in treatment. In the past, it was known that the frontrunner in such infections is s with little emphasis placed on non-albicans species (NAC). Studies worldwide have shown a rise in fungal infections attributed to non-albicans species. The aim of this study is to describe the epidemiology of NAC infections along with an overview of resistance in Lebanese hospitals.

METHODS

This is a two-year observational multi-central descriptive study. Between September 2016 and May of 2018, a total of 1000 isolates were collected from 10 different hospitals distributed all over the country. For the culture, Sabouraud Dextrose Agar was used. Antifungal Susceptibility was evaluated by determining the Minimum Inhibitory Concentration (MIC) in broth (microdilution) of the different antifungal treatments.

RESULTS

Out of the 1000 collected isolates, , being the most isolated species (40.8%), followed by : 231(23.1%), : 103(10.3%), nd other NAC species at lower percentage. Most of these isolates (88.67%) were susceptible to posaconazole, 98.22% were susceptible to micafungin, and 10% were susceptible to caspofungin.

CONCLUSION

The change of etiology of fungal infections involving a significant increase in NAC cases is alarming due to the different antifungal susceptibility patterns and the lack of local guidelines to guide the treatment. In this context, proper identification of such organisms is of utmost importance. The data presented here can help in establishing guidelines for the treatment of candida infections to decrease morbidity and mortality. Future surveillance data are needed.

摘要

背景

侵袭性真菌感染的治疗一直是个挑战。过去,我们知道真菌感染的主要病原体是念珠菌,而非念珠菌属(NAC)物种则较少受到关注。世界各地的研究表明,真菌感染的病例呈上升趋势,且归因于非念珠菌属物种。本研究旨在描述黎巴嫩医院 NAC 感染的流行病学,并概述其耐药情况。

方法

这是一项为期两年的观察性多中心描述性研究。2016 年 9 月至 2018 年 5 月期间,从分布在全国各地的 10 家不同医院共采集了 1000 株分离株。采用沙氏葡萄糖琼脂进行培养。通过肉汤微量稀释法测定不同抗真菌药物的最小抑菌浓度(MIC)来评估抗真菌药敏性。

结果

在所采集的 1000 株分离株中,白色念珠菌(40.8%)最为常见,其次是近平滑念珠菌(23.1%)、热带念珠菌(10.3%)和其他 NAC 物种(<10%)。这些分离株中,88.67%对泊沙康唑敏感,98.22%对米卡芬净敏感,10%对卡泊芬净敏感。

结论

由于 NAC 病例的抗真菌药敏模式不同,且缺乏当地指南来指导治疗,真菌感染的病因学发生了变化,这令人担忧。在这种情况下,正确鉴定这些病原体至关重要。这里提供的数据有助于制定治疗念珠菌感染的指南,以降低发病率和死亡率。需要进一步监测数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1da/10036786/b713383bd3af/fpubh-11-1115055-g0001.jpg

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