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白色念珠菌——为世界卫生组织真菌优先病原体清单提供信息的系统综述。

Candida albicans-A systematic review to inform the World Health Organization Fungal Priority Pathogens List.

机构信息

Sydney Infectious Diseases Institute, The University of Sydney, Sydney, NSW, Australia.

Westmead Institute for Medical Research, Westmead, NSW, Australia.

出版信息

Med Mycol. 2024 Jun 27;62(6). doi: 10.1093/mmy/myae045.

Abstract

Candida albicans is a common fungal pathogen and amongst the leading causes of invasive candidiasis globally. This systematic review examines the characteristics and global impact of invasive infections caused by C. albicans. We searched on PubMed and Web of Science for studies reporting on criteria such as mortality, morbidity, drug resistance, preventability, yearly incidence, and distribution/emergence during the period from 2016 to 2021. Our findings indicate that C. albicans is the most common Candida species causing invasive disease and that standard infection control measures are the primary means of prevention. However, we found high rates of mortality associated with infections caused by C. albicans. Furthermore, there is a lack of data on complications and sequelae. Resistance to commonly used antifungals remains rare. Although, whilst generally susceptible to azoles, we found some evidence of increasing resistance, particularly in middle-income settings-notably, data from low-income settings were limited. Candida albicans remains susceptible to echinocandins, amphotericin B, and flucytosine. We observed evidence of a decreasing proportion of infections caused by C. albicans relative to other Candida species, although detailed epidemiological studies are needed to confirm this trend. More robust data on attributable mortality, complications, and sequelae are needed to understand the full extent of the impact of invasive C. albicans infections.

摘要

白色念珠菌是一种常见的真菌病原体,也是全球侵袭性念珠菌病的主要致病原因之一。本系统综述考察了白色念珠菌引起的侵袭性感染的特征和全球影响。我们在 PubMed 和 Web of Science 上检索了 2016 年至 2021 年期间报告死亡率、发病率、耐药性、可预防性、年发生率和分布/出现情况等标准的研究。我们的研究结果表明,白色念珠菌是引起侵袭性疾病的最常见念珠菌,标准的感染控制措施是主要的预防手段。然而,我们发现白色念珠菌感染相关的死亡率很高。此外,关于并发症和后遗症的数据也很缺乏。尽管常用抗真菌药物的耐药性仍然罕见,但我们发现唑类药物的耐药性有所增加,特别是在中等收入国家,而低收入国家的数据则有限。白色念珠菌仍然对棘白菌素类、两性霉素 B 和氟胞嘧啶敏感。我们观察到与其他念珠菌相比,由白色念珠菌引起的感染比例呈下降趋势,但需要更详细的流行病学研究来证实这一趋势。需要更多关于归因死亡率、并发症和后遗症的可靠数据,以了解侵袭性白色念珠菌感染的全部影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0a94/11210619/9c51ebe36a05/myae045fig1.jpg

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