Ortiz-Roa Cynthia, Valderrama-Rios Martha Carolina, Sierra-Umaña Sebastián Felipe, Rodríguez José Yesid, Muñetón-López Gerardo Antonio, Solórzano-Ramos Carlos Augusto, Escandón Patricia, Alvarez-Moreno Carlos Arturo, Cortés Jorge Alberto
Department of Internal Medicine, Faculty of Medicine, Universidad Nacional de Colombia, Bogotá 111321, Colombia.
Subred Integrada de Servicios de Salud Sur E.S.E. Hospital Tunal, Bogotá 110621, Colombia.
J Fungi (Basel). 2023 Jun 29;9(7):715. doi: 10.3390/jof9070715.
is an emerging pathogen considered to be critical in the World Health Organization fungal organisms list. The study aims to determine the mortality and hospital stays attributed to () compared to other species in adult patients with candidemia. A retrospective cohort of adults with candidemia was examined from seven centres in Colombia between 2016 and 2021. The primary outcome was 30-day mortality, and the secondary outcome was the length of hospital stay among survivors. Adjustment of the confounding variables was performed using inverse probability weights of exposure propensity score (candidemia by ), survival regression models (Weibull distribution), and a counting model (negative binomial distribution). A value of 244 (47.6%) of the 512 patients with candidemia died within the first 30 days. The crude mortality in was 38.1% vs. 51.1% in non-auris (CNA). In the Weibull model, mortality in the group was lower (adjusted HR: aHR- 0.69, 95% CI: 0.53-0.90). Antifungal treatment also decreased mortality, with an aHR of 0.36 (95% CI 0.27-0.47), while the presence of septic shock on patient progression increased it, with an aHR of 1.73 (95% CI 1.41-2.13). Among the patients who survived, no differences in the length of hospital stay were observed between the and the CNA groups, with an incidence rate ratio of 0.92 (95% CI: 0.68-1.22). Mortality in patients with bloodstream infections appears lower when adjusted for numerous confounding variables regarding treatment and the presence of septic shock in patient progression. We identified no significant effect of on the length of hospital stay in surviving patients.
是一种新兴病原体,被认为在世界卫生组织真菌生物列表中至关重要。该研究旨在确定与其他念珠菌属物种相比,成年念珠菌血症患者中由()导致的死亡率和住院时间。对2016年至2021年期间来自哥伦比亚七个中心的成年念珠菌血症患者进行回顾性队列研究。主要结局是30天死亡率,次要结局是幸存者的住院时间。使用暴露倾向评分的逆概率权重(念珠菌血症由)、生存回归模型(威布尔分布)和计数模型(负二项分布)对混杂变量进行调整。512例念珠菌血症患者中有244例(47.6%)在头30天内死亡。耳念珠菌的粗死亡率为38.1%,而非耳念珠菌(CNA)为51.1%。在威布尔模型中,耳念珠菌组的死亡率较低(调整后风险比:aHR - 0.69,95%置信区间:0.53 - 0.90)。抗真菌治疗也降低了死亡率,aHR为0.36(95%置信区间0.27 - 0.47),而患者病情进展时出现感染性休克会增加死亡率,aHR为1.73(95%置信区间1.41 - 2.13)。在幸存者中,耳念珠菌组和CNA组之间的住院时间没有差异,发病率比为0.92(95%置信区间:0.68 - 1.22)。在对治疗和患者病情进展中感染性休克的存在等众多混杂变量进行调整后,耳念珠菌血流感染患者的死亡率似乎较低。我们发现耳念珠菌对存活患者的住院时间没有显著影响。