Division of Medicine, Sheikh Khalifa Specialty Hospital, Ras Al Khaimah, UAE.
Department of Pulmonology, Seoul National University Hospital, Seoul, Republic of Korea.
Med Mycol. 2024 Sep 6;62(9). doi: 10.1093/mmy/myae086.
Candida auris is a pathogen of growing public health concern worldwide. However, risk factors contributing to C. auris infection in patients colonized with C. auris remain unclear. Understanding these risk factors is crucial to prevent colonization-to-infection transition and devise effective preventive strategies. This study aimed to investigate risk factors associated with C. auris infection compared to colonization. The study included 97 patients who acquired laboratory-confirmed C. auris in either matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry or VITEK 2 system from October 2019 to June 2023. Baseline demographics and known risk factors associated with C. auris infection were collected from electronic medical records. The infection group had C. auris from a sterile site or non-sterile site with evidence of infection. The colonization group was followed up for a median of 30 days for any signs of infection. Associations between relevant variables and C. auris infection were assessed using multivariable logistic regression. The infection group (n = 31) was more likely to be bedbound, with longer hospital stays and more arterial catheters. Chronic kidney disease (odds ratio [OR] 45.070), carriage of multidrug-resistant organisms (OR 64.612), and vasopressor use for > 20 days (OR 68.994) were associated with C. auris infection, after adjusting for sex, age, and prior colonization with C. auris. Chronic kidney disease, carriage of multidrug-resistant organisms, and prolonged vasopressor use emerged as significant risk factors for C. auris infection compared to colonization. They could be used to predict C. auris infection early in patients colonized with C. auris.
耳念珠菌是一种日益受到全球公共卫生关注的病原体。然而，导致定植耳念珠菌的患者发生感染的风险因素仍不清楚。了解这些风险因素对于预防定植向感染的转变和制定有效的预防策略至关重要。本研究旨在调查与感染相比，与定植相关的风险因素。该研究纳入了 2019 年 10 月至 2023 年 6 月期间，通过基质辅助激光解吸电离飞行时间（MALDI-TOF）质谱或 VITEK 2 系统确诊为实验室确认的耳念珠菌感染的 97 例患者。从电子病历中收集了感染组和定植组的基线人口统计学和与耳念珠菌感染相关的已知风险因素。感染组的耳念珠菌来自无菌部位或非无菌部位，伴有感染证据。定植组在中位随访 30 天内未出现任何感染迹象。使用多变量逻辑回归评估相关变量与耳念珠菌感染之间的关联。感染组（n=31）更有可能卧床不起，住院时间更长，且有更多的动脉导管。慢性肾脏病（优势比[OR]45.070）、携带多药耐药菌（OR64.612）和血管加压素使用时间>20 天（OR68.994）与耳念珠菌感染相关，调整性别、年龄和既往定植耳念珠菌后。与定植相比，慢性肾脏病、携带多药耐药菌和血管加压素使用时间延长是耳念珠菌感染的显著危险因素。它们可用于预测定植耳念珠菌的患者发生耳念珠菌感染。
