Medical Bacteriology Laboratory. Department of Microbiology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico; General Microbiology Laboratory, Department of Microbiology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico.
Medical Bacteriology Laboratory. Department of Microbiology, Escuela Nacional de Ciencias Biológicas, Instituto Politécnico Nacional, Mexico City, Mexico; Hospital General de Zone 252, Instituto Mexicano del Seguro Social, Atlacomulco, State of Mexico, Mexico.
Arch Med Res. 2024 Sep;55(6):103038. doi: 10.1016/j.arcmed.2024.103038. Epub 2024 Jul 16.
Prolonged hospitalization due to the COVID-19 pandemic gathered risk factors for developing invasive candidiasis.
To describe Candida spp. isolated from patients with clinical suspicion of COVID treated in a public hospital specialized in COVID-19 during the pandemic, considering the susceptibility profiles and the risk factors related to the species detected in a positive yeast culture.
From different samples of 33 patients with comorbidities, 42 clinical isolates were identified by VITEK MS Plus. Antifungal susceptibility testing was performed using VITEK 2 Compact with the AST-YS08 card.
The most frequently identified species were C. albicans and C. glabrata, which were also the most common co-infections, Saprochaete capitata, an uncommon yeast was isolated in one patient. 85% of the co-infections were COVID positive and 100% of patients with a co-infection required mechanical ventilation (MV) which has been described as one of the major predisposing factors to candidiasis. Candida species vary in their response to treatment. In this study, 44% of isolates identified as C. glabrata were fluconazole-resistant, which were also immediately susceptible to caspofungin; this profile limits therapeutic options and emphasizes the importance of evaluating the susceptibility profile.
This work highlights the increase in isolation of different Candida species during COVID-19 and the importance of establishing criteria to declare Candida colonization or infection and the correct etiological identification to establish an agent-based antifungal treatment, to reduce the spreading risk of Candida spp. in the hospital environment, mortality, time, and cost of hospitalization.
由于 COVID-19 大流行而导致的住院时间延长，增加了发生侵袭性念珠菌病的风险因素。
描述从在专门治疗 COVID-19 的公立医院中接受 COVID 治疗的具有临床疑似感染患者中分离出的念珠菌属物种，同时考虑到阳性酵母培养物中检测到的物种的药敏谱和相关危险因素。
从 33 名患有合并症的患者的不同样本中，使用 VITEK MS Plus 鉴定出 42 株临床分离株。使用 VITEK 2 Compact 与 AST-YS08 卡进行抗真菌药敏试验。
最常鉴定出的物种是白色念珠菌和光滑念珠菌，它们也是最常见的合并感染，一种罕见的酵母 Saprochaete capitata 从一名患者中分离出来。85%的合并感染患者 COVID 检测呈阳性，100%的合并感染患者需要机械通气（MV），MV 已被描述为念珠菌病的主要诱发因素之一。念珠菌属物种对抗真菌药物的反应有所不同。在本研究中，44%鉴定为光滑念珠菌的分离株对氟康唑耐药，但对卡泊芬净立即敏感；这种表型限制了治疗选择，并强调了评估药敏谱的重要性。
这项工作强调了在 COVID-19 期间不同念珠菌属物种的分离率增加，以及建立标准来宣布念珠菌定植或感染以及正确的病因学鉴定以建立基于病原体的抗真菌治疗的重要性，以降低念珠菌属在医院环境中的传播风险、死亡率、住院时间和费用。
