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Candida auris 血流感染-来自卡塔尔的描述性研究。

Candida auris Blood stream infection- a descriptive study from Qatar.

机构信息

Division of Infectious Diseases, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.

Department of Microbiology, Hamad Medical Corporation, Doha, Qatar.

出版信息

BMC Infect Dis. 2023 Aug 6;23(1):513. doi: 10.1186/s12879-023-08477-5.

Abstract

BACKGROUND

Candida auris is an emerging yeast pathogen that can cause invasive infections, particularly candidemia, in healthcare settings. Candida auris is characterized by resistance to multiple classes of antifungal drugs and high mortality.

OBJECTIVE

To describe the risk factors, clinical characteristics, antifungal susceptibility pattern and outcomes of Candida auris blood stream infection.

METHODS

We conducted a retrospective review of electronic medical records of C. auris fungemia cases in the facilities under Hamad Medical corporation, Qatar from 1/11/2018 to 31/7/2021. Demographic data, risk factors, antibiogram and 30-day outcome are described.

RESULTS

We identified 36 patients with C. auris fungemia. Most of the patients were in intensive care unit following severe COVID-19 pneumonia and had received steroids and broad-spectrum antibiotics. Most cases were central line related. Over 90% of isolates were non-susceptible to fluconazole, while amphotericin B resistance reached 85%. Factors associated with high mortality included initial SOFA score of 9 or above and absence of source control.

CONCLUSION

Our study reveals a concerning 41.6% mortality rate within 30 days of C. auris candidemia. Furthermore, the prevalence of amphotericin B resistance in Qatar exceeds what has been reported in the literature necessitating further exploration. Echinocandins retains nearly 100% susceptibility and should be prioritized as the treatment of choice. These findings emphasize the need for vigilant monitoring and appropriate management strategies to combat C. auris infections and improve patient outcomes.

摘要

背景

耳念珠菌是一种新兴的酵母病原体,可在医疗机构中引起侵袭性感染,尤其是念珠菌血症。耳念珠菌的特点是对多种类别的抗真菌药物具有耐药性,且死亡率较高。

目的

描述耳念珠菌血流感染的危险因素、临床特征、抗真菌药敏模式和结局。

方法

我们对卡塔尔哈马德医疗公司下属机构中 2018 年 11 月 1 日至 2021 年 7 月 31 日期间发生的耳念珠菌菌血症病例的电子病历进行了回顾性分析。描述了人口统计学数据、危险因素、抗生素药敏谱和 30 天结局。

结果

我们共发现 36 例耳念珠菌菌血症患者。大多数患者在重症监护病房中,患有严重的 COVID-19 肺炎,并接受了类固醇和广谱抗生素治疗。大多数病例与中心静脉导管有关。超过 90%的分离株对氟康唑不敏感,而两性霉素 B 的耐药率达到 85%。与高死亡率相关的因素包括初始 SOFA 评分≥9 分和未进行源头控制。

结论

我们的研究显示,耳念珠菌菌血症患者在 30 天内的死亡率为 41.6%。此外,卡塔尔的两性霉素 B 耐药率高于文献报道,需要进一步研究。棘白菌素类药物保持近 100%的敏感性,应作为首选治疗药物。这些发现强调需要进行警惕监测并采取适当的管理策略,以对抗耳念珠菌感染并改善患者结局。

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