Nascimento Teresa, Inácio João, Guerreiro Daniela, Diaz Priscila, Patrício Patrícia, Proença Luís, Toscano Cristina, Barroso Helena
Unidade de Microbiologia Médica, Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical/Universidade Nova de Lisboa, Lisbon, Portugal.
Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511, Caparica, Almada, Portugal.
Infect Prev Pract. 2024 Sep 24;6(4):100403. doi: 10.1016/j.infpip.2024.100403. eCollection 2024 Dec.
For infections antifungal therapy is often empirical and mainly depends on locally antifungal surveillance data, which differs between geographic regions.
To monitor the epidemiology and antifungal susceptibility of spp. from combined axillar-groin samples in intensive care unit (ICU) patients on admission (day1, D1), day 5 (D5) and day 8 (D8).
From 2020 to 2022, 675 patients from three ICUs were enrolled. isolates were identified by MALDI-TOF MS and PCR. antifungals susceptibility tests (AFST) were performed for fluconazole, voriconazole, amphotericin B and anidulafungin, by concentration gradient Etest® strip technique.
Out of 988 swabs, 355 isolates were identified as species from 232 patients, being 89 isolates retrieved from patients that remained colonised at D5 and D8. AFST was conducted for all isolates. The overall rate of resistance to fluconazole was 2.7%, with 3 out of 133 , 2 out of 89 and 2 out of 24 isolates identified as resistant. Voriconazole susceptibility was observed in 99.2% of the isolates, with only one isolate identified as resistant to this triazole. All isolates were susceptible to amphotericin B and 98.5% to anidulafungin. Three spp. exhibited resistance to anidulafungin, , , and .
This study highlights the importance of as a frequent coloniser and showed that antifungal resistance remains uncommon among isolates from ICUs in Portugal. The results may contribute to better management within institutions to guide therapeutic decision making.
对于感染，抗真菌治疗通常是经验性的，主要取决于当地的抗真菌监测数据，而这些数据在不同地理区域有所不同。
监测重症监护病房（ICU）患者入院时（第1天，D1）、第5天（D5）和第8天（D8）腋窝 - 腹股沟联合样本中 属真菌的流行病学和抗真菌药敏情况。
2020年至2022年，招募了来自三个ICU的675名患者。通过基质辅助激光解吸电离飞行时间质谱（MALDI-TOF MS）和聚合酶链反应（PCR）鉴定 真菌分离株。采用浓度梯度Etest®试纸条技术对氟康唑、伏立康唑、两性霉素B和阿尼芬净进行抗真菌药敏试验（AFST）。
在988份拭子中，从232名患者中鉴定出355株 属真菌分离株，其中89株分离株来自在D5和D8时仍处于定植状态的患者。对所有分离株进行了AFST。对氟康唑的总体耐药率为2.7%，在133株 、89株 和24株 分离株中分别有3株、2株和2株被鉴定为耐药。99.2%的分离株对伏立康唑敏感，仅1株 分离株对该三唑类耐药。所有分离株对两性霉素B敏感，对阿尼芬净的敏感率为98.5%。三株 属真菌对阿尼芬净耐药，分别为 、 和 。
本研究强调了 作为常见定植菌的重要性，并表明在葡萄牙ICU的 分离株中，抗真菌耐药性仍然不常见。这些结果可能有助于机构内更好地管理，以指导治疗决策。
