Microbiology, Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Almada, Portugal.
School of Applied Sciences, University of Brighton, Brighton, United Kingdom.
Front Cell Infect Microbiol. 2024 Nov 1;14:1463456. doi: 10.3389/fcimb.2024.1463456. eCollection 2024.
is an emerging pathogen that represents a worldwide health problem due to its global expansion, multidrug resistance, and difficult laboratory identification. Among the risk factors for colonization/infection by , a stay in an intensive care unit (ICU) stands out. This prospective multicenter study aimed to monitor the trend of the local epidemiology of spp. and unveil the prevalence of .
From 2020 to 2022, axillar/inguinal swabs were collected from adult patients at three points: upon admission (D1) and on the fifth (D5) and eighth (D8) days of their ICU stay. We employed culture-based screening methods combined with molecular techniques to identify spp. down to the species level. Specific screening for was conducted using a real-time PCR assay in combination with an improved selective culture medium, mannitol salt agar auris (MSAA). To validate the effectiveness of MSAA, a collection of reference strains representing the four major geographical clades was used.
We enrolled 675 patients, and 355 isolates were retrieved from the 988 swab samples collected. From those, 185/355 (52.1%) were identified as and 170/355 (47.9%) as non- (NAC). MSAA medium showed a specificity of 94.8%, albeit was not detected in this cohort. The dynamics of spp. colonization by ICU were significant at the three collection points. Upon admission, was associated with the Beatriz Ângelo Hospital ICU (=0.003) and with the general Hospital Professor Doutor Fernando Fonseca (FFH) ICU (=0.006). and were associated with FFH ICUs, with the general ICU at D5 (=0.047) and surgical ICU at D8 (=0.012). The dynamics of NAC colonization by ICU were significantly different at D1 (=0.011), D5 (=0.047), and D8 (=0.012).
We developed and implemented a screening protocol for while uncovering the colonization patterns of in the ICU. Our findings contribute to the optimization of overall patient management, ensuring that ICU protocols are resilient and adaptive to emerging fungal threats.
是一种新兴的病原体，由于其在全球范围内的扩张、多药耐药性和难以进行实验室鉴定，已成为一个全球性的健康问题。在 定植/感染的危险因素中，入住重症监护病房（ICU）是一个突出的因素。本前瞻性多中心研究旨在监测本地 种的流行病学趋势，并揭示 的流行情况。
在 2020 年至 2022 年期间，从 3 家医院的成人患者的腋部/腹股沟部位采集拭子，采集时间为入住时（D1）和入住第 5 天（D5）和第 8 天（D8）。我们采用基于培养的筛选方法结合分子技术，将 种鉴定到种的水平。通过实时 PCR 检测结合改良的选择性培养基甘露糖醇盐琼脂奥里斯（MSAA）对 进行特异性筛查。为了验证 MSAA 的有效性，我们使用了代表四大地理分支的一组参考 菌株进行了收集。
我们共纳入 675 名患者，从采集的 988 份拭子样本中检出 355 株分离株。其中，185/355（52.1%）鉴定为 ，170/355（47.9%）为非-（NAC）。MSAA 培养基的特异性为 94.8%，但在本研究队列中未检测到 。ICU 中 种定植的动态在三个采集点均有显著差异。入住时，与 Beatriz Ângelo 医院 ICU 相关（=0.003），与一般医院教授杜多福雷戈·丰塞卡（FFH） ICU 相关（=0.006）。和 与 FFH ICU 相关，普通 ICU 在 D5（=0.047），外科 ICU 在 D8（=0.012）。NAC 定植 ICU 的动态在 D1（=0.011）、D5（=0.047）和 D8（=0.012）时差异显著。
我们开发并实施了一种用于筛查 的方案，同时揭示了 ICU 中 定植的模式。我们的研究结果有助于优化整体患者管理，确保 ICU 方案具有弹性和适应新兴真菌威胁的能力。
