Gülten Ezgi, Çınar Güle, Sarıcaoğlu Elif Mukime, Akdemir İrem, Yılmaz Afife Zeynep, Saldere Elif Hilal, Yörük Fügen
Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Ankara University, 06230 Ankara, Turkey.
J Fungi (Basel). 2025 Jul 24;11(8):552. doi: 10.3390/jof11080552.
(now ) is an emerging pathogen that causes nosocomial candidemia, particularly in intensive care unit (ICU) settings. Its high resistance rates, prolonged environmental persistence, and outbreak potential underscore the need for robust comparative studies with non- species (NACS). In this retrospective, case-control study, adult ICU patients with candidemia were enrolled between April 2022 and October 2024. Clinical data, risk factors, and mortality at 14, 30, and 90 days were compared between the and NACS groups. Univariate and multivariate logistic regression analyses were performed to identify mortality-associated factors. Of the 182 patients analyzed, candidemia due to was identified in 33 (18.1%) cases, while 149 (81.9%) cases involved NACS. Fluconazole resistance ( < 0.001), prior antifungal exposure ( = 0.003), urinary catheter use ( = 0.040), and the length of ICU stay before the onset of candidemia ( < 0.001) were significantly higher in the cases. However, mortality rates at 14, 30, and 90 days were similar between the groups ( = 0.331, 0.108, and 0.273, respectively). The Sequential Organ Failure Assessment score was the only consistent independent predictor of mortality at all time points. In the NACS cases, the Pitt Bacteremia Score and sepsis also predicted 30- and 90-day mortality. While late recurrence was more frequent in the cases of , early recurrence and other risk factors were similar between the groups. candidemia was associated with higher fluconazole resistance, prior antifungal use, longer ICU stay, more frequent urinary catheterization, and later recurrence than the NACS cases. However, the mortality rates at 14, 30, and 90 days were comparable. Outcomes were primarily influenced by illness severity rather than the infecting species, highlighting the importance of timely therapy, stewardship, and infection control.
(某菌名,原文未完整给出)是一种新兴病原体,可导致医院获得性念珠菌血症,尤其是在重症监护病房(ICU)环境中。其高耐药率、在环境中较长的持续存在时间以及爆发潜力凸显了对其与非该菌种(NACS)进行有力比较研究的必要性。在这项回顾性病例对照研究中,2022年4月至2024年10月期间纳入了患有念珠菌血症的成年ICU患者。比较了该菌组和NACS组的临床数据、危险因素以及14天、30天和90天的死亡率。进行单因素和多因素逻辑回归分析以确定与死亡率相关的因素。在分析的182例患者中,33例(18.1%)为该菌引起的念珠菌血症,而149例(81.9%)为NACS引起。该菌感染病例中氟康唑耐药率(<0.001)、先前使用抗真菌药物(=0.003)、使用导尿管(=0.040)以及念珠菌血症发作前的ICU住院时间(<0.001)显著更高。然而,两组在14天、30天和90天的死亡率相似(分别为=0.331、0.108和0.273)。序贯器官衰竭评估评分是所有时间点唯一一致的死亡率独立预测因素。在NACS病例中,皮特菌血症评分和脓毒症也可预测30天和90天死亡率。虽然该菌感染病例中晚期复发更频繁,但两组之间早期复发和其他危险因素相似。与NACS病例相比,该菌引起的念珠菌血症与更高的氟康唑耐药率、先前使用抗真菌药物、更长的ICU住院时间、更频繁的导尿以及更晚的复发相关。然而,14天、30天和90天的死亡率相当。结局主要受疾病严重程度影响,而非感染的该菌种,这凸显了及时治疗、管理和感染控制的重要性。