Meneghello Silvia, Bernabè Giulia, Di Pietra Giuseppe, Di Sopra Sarah, Del Vecchio Claudia, Cattelan Anna Maria, Castagliuolo Ignazio, Brun Paola
Microbiology and Virology Unit, Padova University Hospital, Via Giustiniani 2, 35128 Padua, Italy.
Department of Molecular Medicine, Section of Microbiology, University of Padova, Via A. Gabelli 63, 35127 Padova, Italy.
J Fungi (Basel). 2024 Oct 10;10(10):707. doi: 10.3390/jof10100707.
Candidemia and invasive candidiasis (IC) are causes of morbidity and mortality in healthcare settings, with notable differences between children and adults. Understanding the species distribution and antimicrobial susceptibility profiles of clinical isolates can guide empiric therapy in patients at risk of IC. This study investigated the incidence and antifungal susceptibility patterns of yeasts involved in IC in pediatric and adult patients from 2019 to 2023. The average incidence of IC was 0.715 per 1000 patients, increasing over the study period; infants had the highest incidence rates. Over half of the IC episodes occurred in intensive care units (ICUs). Non- (NAC) species represented the most frequently isolated species in adults and children (55.96% and 50.0%, respectively), with the prevalence of (26.45% and 14.7%, respectively), (14.97% and 8.82%, respectively) and (4.36% and 2.94%, respectively). was identified in 14.7% of pediatric IC cases. In NAC species, antifungal resistance has also increased over the five years of the study: 69.12% were resistant to azoles and 7.35% were resistant to micafungin. Resistance was higher in pediatric patients. Our study highlights differences in IC characteristics between pediatric and adult populations and emphasizes the importance of targeted antifungal stewardship in ICU patients with NAC invasive infections.
念珠菌血症和侵袭性念珠菌病（IC）是医疗机构中发病和死亡的原因，儿童和成人之间存在显著差异。了解临床分离株的菌种分布和抗菌药物敏感性谱可指导IC高危患者的经验性治疗。本研究调查了2019年至2023年儿科和成人患者中与IC相关的酵母菌的发病率和抗真菌药敏模式。IC的平均发病率为每1000例患者0.715例，在研究期间有所增加；婴儿的发病率最高。超过一半的IC发作发生在重症监护病房（ICU）。非白色念珠菌（NAC）菌种是成人和儿童中最常分离出的菌种（分别为55.96%和50.0%），白色念珠菌的患病率分别为26.45%和14.7%，近平滑念珠菌分别为14.97%和8.82%，热带念珠菌分别为4.36%和2.94%。在14.7%的儿科IC病例中鉴定出光滑念珠菌。在NAC菌种中，抗真菌耐药性在研究的五年中也有所增加：69.12%对唑类耐药，7.35%对米卡芬净耐药。儿科患者的耐药性更高。我们的研究强调了儿科和成人人群在IC特征方面的差异，并强调了对NAC侵袭性感染的ICU患者进行有针对性的抗真菌管理的重要性。
