希腊北部一家三级医院中引起血流感染的菌种的流行病学变化：的出现。（注：原文中部分内容缺失具体菌种名称等关键信息，导致译文可能不太完整准确，但仅按要求进行了字面翻译。）

Changing Epidemiology of spp. Causing Bloodstream Infections in a Tertiary Hospital in Northern Greece: Appearance of .

作者信息

Pyrpasopoulou Athina, Zarras Charalampos, Mouloudi Eleni, Vakalis Georgios, Ftergioti Argyro, Kouroupis Dimitrios, Papathanasiou Anastasia-Izampella, Iosifidis Elias, Goumperi Stella, Lampada Charis, Terzaki Maria, Roilides Emmanuel

机构信息

2nd Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, 54642 Thessaloniki, Greece.

Infectious Diseases Unit, Hippokration General Hospital, 54642 Thessaloniki, Greece.

出版信息

Pathogens. 2025 Feb 7;14(2):161. doi: 10.3390/pathogens14020161.

DOI:10.3390/pathogens14020161

PMID:40005536

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11858320/

Abstract

INTRODUCTION

The epidemiology of candidemia has shifted in the past few decades; drug-resistant species have become more prevalent worldwide. The aim of this retrospective study was to determine the epidemiology of species isolated from hospitalized neonates, children and adults, and to investigate a potential changing susceptibility pattern in a large general tertiary hospital.

METHODS

All unique strains isolated from candidemia cases between 1 January 2020 and 15 October 2024 were identified, and their susceptibility profile was characterized. The distribution pattern in different ward types (medical, surgical, pediatric and ICU) was recorded. Cumulative annual susceptibility profiles were compared.

RESULTS

Candidemia incidence increased during the COVID-19 pandemic, from 0.63/1000 patient-days in 2020 to 0.96/1000 patient-days in 2022, and has since slightly decreased (0.83 and 0.89 in 2023 and 2024, respectively). Candidemia-associated mortality was high (>50%) in 2020 and peaked during the pandemic. During the study period, remained the most frequent spp. However, since the first isolation of from the bloodstream in late 2022, and despite intense infection control measures taken, its frequency sharply climbed to the second position after only in the first 10 months of 2024 (33.6% vs. 25.2% for and 21.0% for ). While has remained highly susceptible to fluconazole (1% resistance rate), manifested significant resistance to fluconazole during 2022-2024 (52%). was universally resistant to azoles and one isolate also resistant to echinocandins.

CONCLUSIONS

A high prevalence of azole resistance of the most frequently isolated species, persists, and a significant rise of was recorded in nosocomial bloodstream infections with severe implications on public health.

摘要

引言

念珠菌血症的流行病学在过去几十年中发生了变化；耐药菌种在全球范围内变得更加普遍。这项回顾性研究的目的是确定从住院新生儿、儿童和成人中分离出的菌种的流行病学情况，并调查一家大型综合三级医院中潜在的药敏模式变化。

方法

对2020年1月1日至2024年10月15日期间从念珠菌血症病例中分离出的所有独特菌株进行鉴定，并对其药敏情况进行表征。记录不同病房类型（内科、外科、儿科和重症监护病房）的分布模式。比较年度累积药敏情况。

结果

在新冠疫情期间念珠菌血症发病率有所上升，从2020年的0.63/1000患者日升至2022年的0.96/1000患者日，此后略有下降（2023年和2024年分别为0.83和0.89）。2020年念珠菌血症相关死亡率很高（>50%），在疫情期间达到峰值。在研究期间，仍然是最常见的念珠菌属菌种。然而，自2022年末首次从血液中分离出以来，尽管采取了严格的感染控制措施，其发生率在2024年的前10个月中仅在之后急剧攀升至第二位（为33.6%，为25.2%，为21.0%）。虽然对氟康唑仍高度敏感（耐药率为1%），但在2022 - 2024年期间对氟康唑表现出显著耐药（52%）。对唑类普遍耐药，且有一株分离株对棘白菌素类也耐药。