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一家三级护理医院的慢性肾脏病患者中的毛孢子菌感染——病例系列还是暴发?一个未解决的问题却是一个管理良好的问题。

Trichosporon infection in chronic kidney disease patients from a tertiary care hospital - a case series or an outbreak? An unanswered question but a well-managed problem.

作者信息

Hassan Heera, Nair L Alina, N S Varsha, R Jyothi, Reghukumar Aravind, M C Sathyabhama, R G Ragi, Kishor Neethu, M G Mithu, Ali Syed, Gopal Kiran, S Manjusree, Koramboor Swathi V, U Anuja

机构信息

Department of Microbiology, Government Medical College, Thiruvananthapuram, India.

Department of Infectious Diseases, Government Medical College, Thiruvananthapuram, India.

出版信息

GMS Infect Dis. 2024 Nov 11;12:Doc05. doi: 10.3205/id000090. eCollection 2024.

Abstract

While the majority of spp. isolated in clinical laboratories are typically associated with episodes of colonization or superficial infections, this fungal species has gained recognition as an opportunistic pathogen, leading to invasive infections worldwide. In this article, we present a case series of spp. identified through conventional methods, complemented by MALDI-TOF analysis from a reference institute for a single sample. The reported cases occurred within a confined time frame, and the construction of an epidemic curve suggested a common source with intermittent exposure. Despite the absence of identified breaches in infection prevention and control (IPC) in units with common exposure, this case series underscores the significance of considering Trichosporonosis in the differential diagnoses for post-transplant and chronic kidney disease patients, particularly those undergoing hemodialysis or utilizing Foley's catheter. Notably, research gaps were identified, emphasizing the need for further exploration of factors such as the role of magnesium and prolonged antibiotic usage in the development of invasive infections and newer treatment modalities against biofilm producing yeast like fungi.

摘要

虽然临床实验室分离出的大多数菌种通常与定植或浅表感染发作有关,但这种真菌已被公认为一种机会性病原体,在全球范围内导致侵袭性感染。在本文中,我们展示了一系列通过传统方法鉴定的菌种病例,并辅以来自一家参考机构对单个样本的基质辅助激光解吸电离飞行时间质谱(MALDI-TOF)分析。报告的病例发生在一个有限的时间范围内,流行曲线的构建表明存在间歇性暴露的共同来源。尽管在有共同暴露的单位中未发现感染预防与控制(IPC)方面的明确漏洞,但该病例系列强调了在移植后和慢性肾病患者,特别是接受血液透析或使用导尿管的患者的鉴别诊断中考虑毛孢子菌病的重要性。值得注意的是,发现了研究空白,强调需要进一步探索诸如镁的作用和长期使用抗生素在侵袭性感染发展中的作用以及针对产生生物膜的酵母样真菌的新型治疗方式等因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3914/11636554/74f1df71d6e1/ID-12-05-t-001.jpg

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