Gregorczyk-Maga Iwona, Kania Michal, Sulik-Tyszka Beata, Namysł Magdalena, Sepioło Anna, Romaniszyn Dorota, Jachowicz-Matczak Estera, Wójkowska-Mach Jadwiga
Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, ul. Montelupich 4, 31-155 Kraków, Poland.
Doctoral School of Medicine and Health Sciences, Jagiellonian University Medical College, ul. św. Anny 12, 31-008 Kraków, Poland.
Microorganisms. 2023 May 30;11(6):1442. doi: 10.3390/microorganisms11061442.
Critically ill COVID-19 patients requiring mechanical ventilation in the intensive care unit are at risk of developing invasive candidiasis. In this study we aimed to (1) characterize oral cultivable mycobiota of mechanically ventilated adult COVID-19 patients in an ICU setting by sampling four distinct oral niches in two fixed time points with regards to oral health status, (2) investigate spp. infections in this population, and (3) compare oral mycobiota with selected bacteriobiota strains during the observation in the ICU. We recruited 56 adult COVID-19 patients who qualified for mechanical ventilation. Patients received either standard or extended oral care procedures with tooth brushing. Oral samples were taken first within 36 h and after 7 days of intubation. Yeast-like fungi were identified by MALDI/TOF mass spectrometry. Yeast infection cases were retrospectively analyzed. spp. in oral sampling was identified in 80.4% and 75.7%, in 57.1% and 61.1%, and - species in 48.2% and 47.2% patients at baseline and follow-up, respectively. There were no differences in the overall CFU counts of spp. species and individual species in oral samples, both at baseline and follow-up. At baseline, a higher prevalence of spp. was associated with a higher identification rate of spp. (64.4% vs. 27.3%, = 0.041). At follow-up, there was a borderline lower prevalence of spp. in patients with spp. identified (57.1% vs. 87.0%, = 0.057). The incidence rate of candidiasis was 5.4% and the incidence density was 3.1/1000 pds. In conclusion, species in oral samples were identified in nearly half of patients. Oral health was moderately impaired. A high incidence of yeast infections, including invasive cases, in patients hospitalized in the ICU due to COVID-19 and requiring mechanical ventilation was noted. Severe COVID-19 and disease-specific interventions within the ICU possibly played a major role promoting spp. infections.
在重症监护病房需要机械通气的重症 COVID-19 患者有发生侵袭性念珠菌病的风险。在本研究中,我们旨在:(1)通过在两个固定时间点对机械通气的成年 COVID-19 患者的四个不同口腔部位进行采样,以口腔健康状况为依据,对重症监护病房环境中此类患者的口腔可培养真菌群进行特征描述;(2)调查该人群中的 spp. 感染情况;(3)在重症监护病房观察期间,将口腔真菌群与选定的细菌菌株进行比较。我们招募了 56 名符合机械通气条件的成年 COVID-19 患者。患者接受了标准或延长的口腔护理程序,包括刷牙。口腔样本在插管后 36 小时内及 7 天后采集。通过 MALDI/TOF 质谱法鉴定酵母样真菌。对酵母感染病例进行回顾性分析。在基线和随访时,分别有 80.4%和 75.7%的患者在口腔采样中鉴定出 spp.,57.1%和 61.1%的患者鉴定出 ,48.2%和 47.2%的患者鉴定出 - 种。在基线和随访时,口腔样本中 spp. 物种和单个 物种的总菌落形成单位计数均无差异。在基线时, spp. 的较高患病率与 spp. 的较高鉴定率相关(64.4%对 27.3%, = 0.041)。在随访时,鉴定出 spp. 的患者中 spp. 的患病率略低(57.1%对 87.0%, = 0.057)。念珠菌病的发病率为 5.4%,发病密度为 3.1/1000 人日。总之,近一半的患者在口腔样本中鉴定出 物种。口腔健康受到中度损害。注意到因 COVID-19 在重症监护病房住院并需要机械通气的患者中,酵母感染(包括侵袭性病例)的发生率很高。重症 COVID-19 和重症监护病房内针对疾病的干预措施可能在促进 spp. 感染方面起主要作用。