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新兴医疗威胁——耳念珠菌:来自印度西部农村三级转诊中心的患病率研究

Emerging Healthcare Threat Candida auris: A Prevalence Study From a Rural Tertiary Referral Centre in Western India.

作者信息

Tajane Savita B, Pawar Satyajeet, Patil Satish

机构信息

Department of Microbiology, Krishna Institute of Medical Sciences, Krishna Vishwa Vidyapeeth (Deemed to be University), Karad, IND.

出版信息

Cureus. 2024 Oct 30;16(10):e72676. doi: 10.7759/cureus.72676. eCollection 2024 Oct.

Abstract

Background has emerged as an important healthcare-associated pathogen that has high mortality rates. Additionally, this pathogen can cause nosocomial outbreaks. However, in comparison to the vast majority of the pathogenic species from the genus Candida, is difficult to treat and identify by using conventional therapeutic and diagnostic modalities. The exact prevalence of this pathogen is largely unclear from Indian healthcare setups. This study aimed to determine the prevalence of in a tertiary care academic hospital in western Maharashtra and to study the associated risk factors of patients with infection. Methods Candida isolates were identified using conventional methods, including the germ tube test and colony morphology assessment on HiChrom™ Candida differential agar (Hi Media, Thane, India). Species-level identification was performed with the VITEK 2 system (version 8.01, BioMérieux, Marcy-l'Étoile, France), and was confirmed using Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry (MALDI-TOF-MS). Patient records were retrieved from patient files and reviewed retrospectively for demographic variables, risk factors, clinical conditions, treatment, and outcome. Results was isolated from nine clinical specimens. The prevalence of was 9.4% among non-albicans Candida species (n=96), whereas the prevalence of among total Candida isolates (n=147) was noted to be 6.1%. Multiple hospitalizations, ICU stay, comorbidities like chronic kidney disease, diabetes mellitus and hypertension along with concomitant bacterial infection and broad-spectrum antimicrobial therapy were associated risk factors. Conclusion In this study, was most predominantly isolated from urine specimens. The urinary tract infection (UTI) should not be ignored as at times it may progress to disseminated infection, especially in patients with comorbidities. The current study underlines the importance of automated systems for identifying . Prompt identification will aid in treatment whereas the implementation of infection prevention and control measures will help in the containment of infection spread in a healthcare setup.

摘要

背景

已成为一种重要的医疗保健相关病原体,死亡率很高。此外,这种病原体可导致医院感染暴发。然而,与念珠菌属的绝大多数致病菌种相比,使用传统的治疗和诊断方法很难对其进行治疗和鉴定。在印度的医疗保健机构中,这种病原体的确切流行情况很大程度上尚不清楚。本研究旨在确定马哈拉施特拉邦西部一家三级护理学术医院中的流行情况,并研究感染患者的相关危险因素。方法:使用常规方法鉴定念珠菌分离株,包括芽管试验和在HiChrom™念珠菌鉴别琼脂(印度塔那市Hi Media公司)上进行菌落形态评估。使用VITEK 2系统(版本8.01,法国马西伊图瓦勒市生物梅里埃公司)进行菌种水平鉴定,并使用基质辅助激光解吸电离飞行时间质谱(MALDI-TOF-MS)进行确认。从患者档案中检索患者记录,并回顾性审查人口统计学变量、危险因素、临床状况、治疗和结局。结果:从9份临床标本中分离出。在非白色念珠菌菌种中(n=96)的流行率为9.4%,而在所有念珠菌分离株中(n=147)的流行率为6.1%。多次住院、入住重症监护病房、慢性肾病、糖尿病和高血压等合并症以及合并细菌感染和广谱抗菌治疗是相关危险因素。结论:在本研究中,主要从尿液标本中分离出。尿路感染(UTI)不应被忽视,因为有时它可能进展为播散性感染,尤其是在合并症患者中。当前研究强调了自动化系统对鉴定的重要性。及时鉴定将有助于治疗,而实施感染预防和控制措施将有助于遏制医疗保健机构中感染的传播。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da34/11605486/25505fb3b189/cureus-0016-00000072676-i01.jpg

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