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实体器官移植受者酵母菌定植与感染的临床特征及结局:分离株的分子鉴定与抗真菌药敏模式

Clinical characteristics and outcomes of colonization and infection by yeast species in solid organ transplant recipients: Molecular identification and antifungal susceptibility patterns of isolates.

作者信息

Yazdanpanah Somayeh, Shafiekhani Mojtaba, Ahmadi Mohammad, Zare Zahra, Nikoupour Hamed, Arabsheybani Sara, Geramizadeh Bita, Anbardar Mohammad-Hossein, Chamanpara Parisa, Badali Hamid, Moghadami Mohsen, Pakshir Keyvan, Zomorodian Kamiar

机构信息

Department of Medical Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Med Mycol. 2024 Dec 27;63(1). doi: 10.1093/mmy/myae118.

Abstract

Fungal infections are serious complications after solid organ transplantation, with high mortality and morbidity. Given the importance of the local epidemiological data and also extensive prophylactic regimens in solid organ transplant (SOT) recipients, this study aimed to investigate the clinical characteristics and resistance patterns of yeast isolates in SOT recipients at a main referral transplant center in Iran. Of the 275 recipients enrolled, 22 (8%) had at least one positive yeast culture at a median of 5 days after transplantation. Bacterial infection and reoperation were significantly associated with colonization or infection caused by yeast species (P = .001). Moreover, mortality and length of ICU/hospital stay were significantly higher in patients with positive yeast cultures (P < .05). The most frequent species isolated was Candida albicans (50%), followed by C. glabrata (22.7%). Of species with definite breakpoints, the fluconazole-resistant rate was 23%. Caspofungin and amphotericin B showed potent activity against all isolates. Regarding the high risk of fungal infections, awareness of local epidemiological trends and resistance patterns can help improve outcomes in SOT recipients.

摘要

真菌感染是实体器官移植后的严重并发症,死亡率和发病率都很高。鉴于当地流行病学数据的重要性以及实体器官移植(SOT)受者广泛的预防方案,本研究旨在调查伊朗一家主要转诊移植中心SOT受者中酵母菌分离株的临床特征和耐药模式。在纳入的275名受者中,22名(8%)在移植后中位时间5天时至少有一次酵母菌培养呈阳性。细菌感染和再次手术与酵母菌属引起的定植或感染显著相关(P = .001)。此外,酵母菌培养阳性的患者死亡率和重症监护病房/住院时间显著更高(P < .05)。分离出的最常见菌种是白色念珠菌(50%),其次是光滑念珠菌(22.7%)。在有明确折点的菌种中,氟康唑耐药率为23%。卡泊芬净和两性霉素B对所有分离株均显示出强效活性。鉴于真菌感染的高风险,了解当地流行病学趋势和耐药模式有助于改善SOT受者的治疗结果。

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