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阿拉伯联合酋长国(阿联酋)一家三级医院中耳念珠菌感染的患病率及转归

Prevalence and Outcomes of Candida auris Infections in a Tertiary Hospital in the United Arab Emirates (UAE).

作者信息

Subhi Ahmad, Alshamsi Salma, Vitus Aulin, Harazeen Akram

机构信息

Department of Infectious Diseases, Al-Qassimi Hospital, Sharjah, ARE.

Department of Prevention and Control of Infection, Al-Qassimi Hospital, Sharjah, ARE.

出版信息

Cureus. 2024 Sep 23;16(9):e69988. doi: 10.7759/cureus.69988. eCollection 2024 Sep.

Abstract

Background () is an emerging serious threat to healthcare settings, with an average mortality of 45% in cases of bloodstream infections. This study aimed to determine the prevalence of in a single center in the UAE during the year 2022 and understand risk factors related to poor outcomes. Methods This retrospective cohort chart review at Al-Qassimi Hospital encompassed all confirmed infections, including , from January to December 2022. The study involved male and female patients aged 13 years and older, using comprehensive data extracted from the hospital's electronic healthcare records. The analysis included clinical, laboratory, and epidemiological data. Adhering to the 2011 Declaration of Helsinki and Good Pharmacoepidemiology Practices, the study received Institutional Review Board approval, with informed consent waived due to its retrospective design. Data were summarized using appropriate statistical methods, including the unpaired t-test, Mann-Whitney U test, Chi-square test, and Fisher exact test. A significance level of 95% (p<0.05) was maintained throughout the statistical analyses. Results Of the 75 confirmed infections, 53 (70.7%) were -positive cases. About 23 (43.4%) of the group were above 65 years old. Most cases of group were hospital-acquired (49, 92.5%). The highest number of positive cases were found in urine samples. The demographic and clinical profiles of the and non- groups candidemia were largely similar, except for differences in antifungal use history and ICU requirements. Notably, the group had a significantly lower history of antifungal use and a lower ICU requirement compared to the non group. The study also highlighted the higher mortality rate associated with candidemia. While mortality was higher in the non- group, the difference was not statistically significant. Conclusions The findings of the study suggest that while poses a serious threat, particularly in hospital settings; the clinical and demographic factors influencing its spread and impact are complex and warrant further investigation. Understanding these factors is crucial for developing effective strategies to prevent and manage infections, particularly in vulnerable patient populations.

摘要

背景 (病原体名称未给出,暂用“某病原体”代替)对医疗机构来说是一种新出现的严重威胁,在血流感染病例中平均死亡率为45%。本研究旨在确定2022年阿联酋一个单一中心的某病原体感染率,并了解与不良结局相关的风险因素。方法 这项在卡西米医院进行的回顾性队列图表审查涵盖了2022年1月至12月所有确诊的某病原体感染,包括念珠菌血症。该研究纳入了年龄在13岁及以上的男性和女性患者,使用从医院电子医疗记录中提取的综合数据。分析包括临床、实验室和流行病学数据。该研究遵循2011年《赫尔辛基宣言》和良好药物流行病学实践,获得了机构审查委员会的批准,由于其回顾性设计,豁免了知情同意。数据使用适当的统计方法进行总结,包括不成对t检验、曼-惠特尼U检验、卡方检验和费舍尔精确检验。在整个统计分析中维持95%(p<0.05)的显著性水平。结果 在75例确诊感染中,53例(70.7%)为某病原体阳性病例。某病原体组中约23例(43.4%)年龄在65岁以上。某病原体组的大多数病例是医院获得性的(49例,92.5%)。尿液样本中阳性病例数量最多。某病原体血症组和非某病原体血症组的人口统计学和临床特征在很大程度上相似,除了抗真菌药物使用史和重症监护病房需求方面的差异。值得注意的是,与非某病原体血症组相比,某病原体血症组的抗真菌药物使用史显著更低,重症监护病房需求也更低。该研究还强调了与念珠菌血症相关的更高死亡率。虽然非某病原体血症组的死亡率更高,但差异无统计学意义。结论 该研究结果表明,虽然某病原体构成严重威胁,特别是在医院环境中;但影响其传播和影响的临床和人口统计学因素很复杂,值得进一步研究。了解这些因素对于制定有效的预防和管理某病原体感染的策略至关重要,特别是在脆弱患者群体中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b06/11497757/65192113e2e4/cureus-0016-00000069988-i01.jpg

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