Balaji Lavanya, Manoharan Harish, Prabhakaran Neelusree, Manivannan Nandhagopal
Department of Microbiology, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Cureus. 2024 Aug 7;16(8):e66364. doi: 10.7759/cureus.66364. eCollection 2024 Aug.
Background -associated catheter-related bloodstream infections (CRBSIs) present a significant challenge in clinical settings, particularly among patients with central venous catheters (CVCs). Time-to-positivity (TTP) of blood cultures, an indicator of fungal load, may provide insights into infection prognosis and severity. This study evaluates the role of TTP in -associated bloodstream infections and its impact on patient outcomes. Materials and methods This cross-sectional observational study, conducted from July 2023 to June 2024 at Saveetha Medical College, involved collecting blood cultures from intensive care unit (ICU) patients with suspected candidemia. Blood cultures were processed using the BacT/ALERT 3D system (bioMérieux, Marcy l'Étoile, France), with TTP recorded for each -positive culture. Species identification was performed using MALDI-TOF MS (Bruker Daltonics, Germany). Species-specific 30-day mortality was analyzed to assess the impact of TTP on survival. Results Of 7447 blood cultures from ICU patients, 2349 were positive, with a 2.42% prevalence of . Among 57 candidemia patients, the median TTP for deceased patients was 24 hours, compared to 25 hours for survivors (p=0.001). exhibited the highest mortality rate (56.25%) with a median TTP of 16.5 hours, whereas had no associated mortality and a median TTP of 28.5 hours. Shorter TTP was consistently associated with higher mortality across . Conclusion This study highlights the prognostic value of TTP in -associated bloodstream infections, with shorter TTP correlating with higher mortality. The findings underscore the need for rapid diagnosis and aggressive treatment, particularly for high-risk species like and . Further research is needed to refine the clinical application of TTP and develop targeted treatment strategies.
背景相关性导管相关血流感染（CRBSIs）在临床环境中是一项重大挑战，尤其是在中心静脉导管（CVC）患者中。血培养的阳性时间（TTP）作为真菌负荷的一个指标，可能为感染的预后和严重程度提供见解。本研究评估了TTP在相关性血流感染中的作用及其对患者结局的影响。材料和方法 这项横断面观察性研究于2023年7月至2024年6月在Saveetha医学院进行，涉及从疑似念珠菌血症的重症监护病房（ICU）患者中采集血培养样本。使用BacT/ALERT 3D系统（法国生物梅里埃公司，马西伊图瓦勒）处理血培养样本，记录每个阳性培养物的TTP。使用基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS，德国布鲁克道尔顿公司）进行菌种鉴定。分析特定菌种的30天死亡率以评估TTP对生存的影响。结果 在ICU患者的7447份血培养样本中，2349份呈阳性，念珠菌血症患病率为2.42%。在57例念珠菌血症患者中，死亡患者的TTP中位数为24小时，而存活患者为25小时（p = 0.001）。某菌种的死亡率最高（56.25%），TTP中位数为16.5小时，而另一菌种无相关死亡，TTP中位数为28.5小时。在所有菌种中，较短的TTP始终与较高的死亡率相关。结论 本研究强调了TTP在相关性血流感染中的预后价值，较短的TTP与较高的死亡率相关。研究结果强调了快速诊断和积极治疗的必要性，特别是对于某些高危菌种。需要进一步研究以完善TTP的临床应用并制定针对性的治疗策略。
