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中国南方临床分离真菌种的流行病学和抗真菌药敏性。

Epidemiology and antifungal susceptibilities of clinically isolated species in South China.

机构信息

Department of Dermatology, Second Affiliated Hospital of Shantou University Medical College, Shantou, China.

Department of Dermatology, Meizhou Dongshan Hospital, Meizhou, Guangdong Province, China.

出版信息

Epidemiol Infect. 2023 Oct 17;151:e184. doi: 10.1017/S095026882300167X.

Abstract

Aspergillosis is a rising concern worldwide; however, its prevalence is not well documented in China. This retrospective study determined epidemiology and antifungal susceptibilities at Meizhou People's Hospital, South China. From 2017 to 2022, the demographic, clinical, and laboratory data about aspergillosis were collected from the hospital's records and analysed using descriptive statistics, chi-square test, and ANOVA. Of 474 aspergillosis cases, (75.32%) was the most common, followed by (9.92%), (8.86%), and (5.91%). A 5.94-fold increase in aspergillosis occurred during the study duration, with the highest cases reported from the intensive care unit (52.74%) - chronic pulmonary aspergillosis (79.1%) and isolated from sputum (62.93%). Only 38 (8.02%) patients used immunosuppressant drugs, while gastroenteritis (5.7%), haematologic malignancy (4.22%), and cardiovascular disease (4.22%) were the most prevalent underlying illnesses. In the wild-type (WT) isolates against amphotericin B (99.1%) were higher than triazoles (97-98%), whereas, in non- species, the triazole (95-100%) WT proportion was greater than amphotericin B (91-95%). Additionally, there were significantly fewer WT isolates for itraconazole and posaconazole in outpatients than inpatients. These findings may aid in better understanding and management of aspergillosis in the region.

摘要

曲霉菌病是全球日益关注的问题;然而,其在中国的流行情况尚未得到充分记录。本回顾性研究旨在确定中国南方梅州市人民医院的曲霉菌病流行病学和抗真菌药敏情况。2017 年至 2022 年,从医院记录中收集了有关曲霉菌病的人口统计学、临床和实验室数据,并使用描述性统计、卡方检验和 ANOVA 进行分析。在 474 例曲霉菌病病例中,最常见的是烟曲霉菌(75.32%),其次是黄曲霉菌(9.92%)、黑曲霉菌(8.86%)和土曲霉菌(5.91%)。在研究期间,曲霉菌病的发病率增加了 5.94 倍,其中重症监护病房(52.74%)报告的病例最多-慢性肺曲霉病(79.1%)和痰液分离株(62.93%)。仅有 38 例(8.02%)患者使用免疫抑制剂药物,而胃肠炎(5.7%)、血液系统恶性肿瘤(4.22%)和心血管疾病(4.22%)是最常见的基础疾病。在野生型(WT)分离株中,两性霉素 B(99.1%)的耐药率高于三唑类(97-98%),而非-种的三唑类(95-100%)WT 比例大于两性霉素 B(91-95%)。此外,门诊患者中伊曲康唑和泊沙康唑的 WT 分离株明显少于住院患者。这些发现可能有助于更好地理解和管理该地区的曲霉菌病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8ca/10644062/3c3bbf0bf95d/S095026882300167X_fig1.jpg

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