Department of Laboratory Medicine, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, China.
Branch of National Clinical Research Center for Laboratory Medicine, Nanjing, China.
Front Cell Infect Microbiol. 2023 Jun 29;13:1079535. doi: 10.3389/fcimb.2023.1079535. eCollection 2023.
() is a lipophilic, conditionally pathogenic yeast that mainly causes skin infections, but the reports of related invasive infections are increasing. The aim of this study is to provide clinical data to assist physicians in the management of patients with invasive infections caused by .
A case of pulmonary infection caused by in a hematopoietic stem cell transplant patient for aplastic anemia was reported. In addition, the literature on invasive infection by published in PubMed and Web of Science in English until 31 July 2022 was reviewed.
Clinical data analysis of 86 patients (from 37 studies and our case) revealed that most of them were preterm (44.2%), followed by adults (31.4%). fungemia occurred in 79.1% of the 86 patients, and 45 of them were clearly obtained from catheter blood. Other patients developed catheter-related infections, pneumonia, peripheral thromboembolism, endocarditis, meningitis, peritonitis and disseminated infections. Thirty-eight preterm infants had underlying diseases such as very low birth weight and/or multiple organ hypoplasia. The remaining patients had compromised immunity or severe gastrointestinal diseases. 97.7% of patients underwent invasive procedures and 80.2% received total parenteral nutrition (TPN). Fever, thrombocytopenia and leukocytosis accounted for 55.8%, 38.4% and 24.4% of patients with invasive infections, respectively. 69.8% of the patients received antifungal therapy, mainly amphotericin B (AmB) or azoles. Of 84 patients with indwelling catheters, 58.3% underwent the removal of catheters. TPN were discontinued in 30 of 69 patients. The all-cause mortality of 86 patients was 27.9%.
can cause a variety of invasive infections. These patients mostly occur in premature infants, low immunity and severe gastrointestinal diseases. Indwelling catheters and TPN infusion are major risk factors. AmB, l-AmB and azoles are the most commonly used agents, and simultaneous removal of the catheter and termination of TPN infusion are important for the treatment of invasive infections.
（）是一种亲脂性、条件致病性酵母，主要引起皮肤感染，但与侵袭性感染相关的报告正在增加。本研究旨在提供临床数据，以协助医生治疗由引起的侵袭性感染。
报告了一例再生障碍性贫血造血干细胞移植患者肺部感染的病例。此外，还回顾了截至 2022 年 7 月 31 日在 PubMed 和 Web of Science 上以英文发表的关于侵袭性感染的文献。
对 86 例患者（来自 37 项研究和我们的病例）的临床数据分析显示，他们大多数是早产儿（44.2%），其次是成年人（31.4%）。86 例患者中有 79.1%发生真菌血症，其中 45 例明确从导管血中获得。其他患者发生导管相关感染、肺炎、外周血栓栓塞、心内膜炎、脑膜炎、腹膜炎和播散性感染。38 例早产儿有极低出生体重和/或多器官发育不全等基础疾病。其余患者免疫功能受损或患有严重胃肠道疾病。97.7%的患者接受了有创操作，80.2%接受了全胃肠外营养（TPN）。发热、血小板减少和白细胞增多分别占侵袭性感染患者的 55.8%、38.4%和 24.4%。69.8%的患者接受了抗真菌治疗，主要是两性霉素 B（AmB）或唑类药物。84 例留置导管的患者中，58.3%的导管被移除。69 例患者中有 30 例停止了 TPN。86 例患者的总死亡率为 27.9%。
可以引起多种侵袭性感染。这些患者大多发生在早产儿、免疫功能低下和严重胃肠道疾病患者中。留置导管和 TPN 输注是主要的危险因素。AmB、两性霉素脂质体和唑类药物是最常用的药物，同时去除导管和停止 TPN 输注对治疗侵袭性感染非常重要。
