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从埃及三级医院入院的念珠菌血症患者中分离出的念珠菌的分布和抗真菌药敏谱:一项横断面研究。

Distribution and antifungal susceptibility profiles of Candida species isolated from candidemia patients admitted to Egyptian tertiary hospitals: a cross-sectional study.

机构信息

Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Clinical Pharmacy Department, Faculty of Medicine, Beni-Suef University Hospitals, Beni-Suef University, Beni-Suef, Egypt.

出版信息

BMC Infect Dis. 2024 Oct 18;24(1):1177. doi: 10.1186/s12879-024-10007-w.

Abstract

BACKGROUND

Candidemia is a widespread threat that can lead to significant complications in healthcare settings.

OBJECTIVES

Our study aimed to identify isolates of Candida isolated from blood culture bottles of patients with candidemia and assess their antifungal susceptibility profiles.

METHODS

We conducted a cross-sectional study at Cairo University tertiary care hospitals over 16 months including 90 patients. Candida isolates were collected from blood culture bottles, and identified using MALDI-TOF MS technology of VITEK MS PRIME (bioMérieux) with the corresponding database VITEK IVD Database 3.2. followed by antifungal susceptibility testing using VITEK 2 Compact system.

RESULTS

Candida albicans was the most common species isolated from both pediatric and adult patients with percentages of 47.3% and 36.4% respectively, followed by Candida parapsilosis with percentages of 32.6% and 25.0% respectively. Voriconazole showed the highest antifungal activity at 90.9% of isolates in adults and 95.7% in pediatrics, followed by caspofungin and micafungin. The mean hospital stays for adults ranged from 8 to 30 days and from 10 to 42 days in the pediatric group.

CONCLUSIONS

C. albicans remains the predominant species isolated from both pediatric and adult candidemia patients, despite a notable increase in other species. C. tropicalis and C. parapsilosis are considered the most common non-albicans Candida (NAC) species. The rise in Candida species other than albicans highlights the urgent need for effective antifungal stewardship programs. Voriconazole exhibited the higher antifungal activity followed by caspofungin and micafungin.

摘要

背景

念珠菌血症是一种广泛存在的威胁,可导致医疗环境中出现严重并发症。

目的

我们的研究旨在鉴定从念珠菌血症患者的血培养瓶中分离出的念珠菌分离株,并评估其抗真菌药敏谱。

方法

我们在开罗大学三级保健医院进行了一项 16 个月的横断面研究,包括 90 名患者。从血培养瓶中采集念珠菌分离株,使用 MALDI-TOF MS 技术的 VITEK MS PRIME(bioMérieux)与相应的数据库 VITEK IVD 数据库 3.2 进行鉴定,然后使用 VITEK 2 Compact 系统进行抗真菌药敏试验。

结果

白色念珠菌是从儿科和成年患者中分离出的最常见的菌种,分别占 47.3%和 36.4%,其次是近平滑念珠菌,分别占 32.6%和 25.0%。伏立康唑在成年患者中的抗真菌活性最高,为 90.9%,在儿科患者中为 95.7%,其次是卡泊芬净和米卡芬净。成年患者的平均住院时间为 8 至 30 天,儿科患者为 10 至 42 天。

结论

尽管其他物种明显增加,但白色念珠菌仍然是从儿科和成年念珠菌血症患者中分离出的主要菌种。热带念珠菌和近平滑念珠菌被认为是最常见的非白念珠菌念珠菌(NAC)。除白色念珠菌以外的念珠菌物种的增加突显了迫切需要有效的抗真菌管理计划。伏立康唑显示出较高的抗真菌活性,其次是卡泊芬净和米卡芬净。

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