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伊朗住院新冠肺炎患者的尿路感染:菌种分布及抗真菌药敏模式

Hospitalized COVID-19 Patients with Urinary Tract Infection in Iran: Species Distribution and Antifungal Susceptibility Patterns.

作者信息

Shiyadeh Zeinab Soleimani, Farahyar Shirin, Vahedi Larijani Laleh, Beardsley Justin, Nouri Noura, Mahmoudi Shahram, Roudbar Mohammadi Shahla, Rodrigues Célia Fortuna, Roudbary Maryam

机构信息

Department of Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran.

Microbial Biotechnology Research Center (MBiRC), School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran.

出版信息

Antibiotics (Basel). 2024 Jul 8;13(7):633. doi: 10.3390/antibiotics13070633.

Abstract

species, typically part of the human skin and mucous membrane flora, can cause opportunistic fungal infections, notably urinary tract infections (UTIs), which are on the rise among hospitalized COVID-19 patients. The lack of understanding of UTIs in this population, coupled with the emergence of multidrug-resistant strains, poses significant challenges for effective treatment and further investigations. In this study, urine samples were collected from 70 COVID-19 patients with UTIs in sterile containers for microbiology examination. After microscopic observation, the isolates were identified both by phenotypic and molecular techniques such as multiplex PCR. Antifungal susceptibility testing (AFST) against fluconazole (Flu), itraconazole (Itr), and amphotericin B (AMB) was performed according to CLSI M27/S4 standard methods, with the frequency of isolates including ( = 20, 51.3%), ( = 15, 38.4%), (previously ) ( = 2, 5.1%), (previously , and ( = 1, 2.5%). All isolates of , , , and were sensitive to amphotericin B, while was resistant to AMB. Around 70% of isolates were sensitive to Flu; 20% of were resistant to itraconazole, while 33% were resistant to fluconazole. and were the main causes of candiduria in infected cases and both Flu and AMB showed good results in AFST in these species. Performing drug susceptibility testing for clinical isolates of spp. provided guidance for appropriate management and control, and timely antifungal treatment.

摘要

该菌种通常是人体皮肤和黏膜菌群的一部分,可引起机会性真菌感染,尤其是尿路感染(UTIs),在住院的COVID-19患者中呈上升趋势。对该人群尿路感染缺乏了解,再加上多重耐药菌株的出现,给有效治疗和进一步研究带来了重大挑战。在本研究中,从70例患有尿路感染的COVID-19患者中收集尿液样本于无菌容器中进行微生物学检查。经过显微镜观察后,通过表型和分子技术如多重PCR对分离株进行鉴定。根据CLSI M27/S4标准方法对氟康唑(Flu)、伊曲康唑(Itr)和两性霉素B(AMB)进行抗真菌药敏试验(AFST),分离株的频率包括白色念珠菌(=20,51.3%)、光滑念珠菌(=15,38.4%)近平滑念珠菌(以前为光滑念珠菌)(=2,5.1%)、热带念珠菌(以前为光滑念珠菌和克柔念珠菌)(=1,2.5%)。白色念珠菌、光滑念珠菌、近平滑念珠菌和热带念珠菌的所有分离株对两性霉素B敏感,而克柔念珠菌对AMB耐药。约70%的白色念珠菌分离株对氟康唑敏感;20%的光滑念珠菌对伊曲康唑耐药,而33%对氟康唑耐药。白色念珠菌和光滑念珠菌是感染病例中念珠菌尿的主要原因,在这些菌种的AFST中氟康唑和两性霉素B均显示出良好效果。对念珠菌属临床分离株进行药敏试验为适当的管理和控制以及及时的抗真菌治疗提供了指导。

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