Kim Dong Young, Oh Keon, Song Minseung, Kweon Hyemin, Nho Dukhee, Hong Hanter, Lee Raeseok, Lee Dong-Gun, Cho Sung-Yeon
Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
Division of Infectious Diseases, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
J Fungi (Basel). 2025 Aug 8;11(8):585. doi: 10.3390/jof11080585.
Invasive yeast infections (IYIs) remain a significant cause of morbidity and mortality in patients with hematologic diseases. We retrospectively analyzed 193 IYI episodes among 179 patients admitted to a tertiary hematology hospital (2012-2023). species accounted for 91.7% (n = 177), while non- yeasts comprised 8.3% (n = 16). Among invasive candidiasis, non- spp. were predominant, representing 76.8% (136/177), with (36.2%, 64/177) being the most frequently isolated species. Among non- yeasts, (n = 10) was the most commonly identified pathogen. The incidence and 42-day mortality rate of IYIs were 0.199 and 0.095 per 1000 patient-days, respectively. The 42-day case-fatality rate remained high at 47.7%. In categorical analysis, age >65 years, corticosteroid use, elevated lactate (>2 mmol/L), neutropenia (<500/mm), vasopressor use, and mechanical ventilation were more common in non-survivors. Primary bloodstream infections were more frequent in non-survivors, whereas catheter-related and abdominal-origin infections were predominant among survivors. Concomitant bacteremia was observed in 32.6% of IYI cases (n = 63), with being the most frequently isolated co-pathogen. Our findings illustrate the evolving epidemiology of IYIs in hematologic patients, marked by the emergence of as the predominant species, sustained mortality, and frequent bacterial co-infections, collectively reflecting the substantial clinical burden of IYIs.
侵袭性酵母菌感染(IYIs)仍是血液病患者发病和死亡的重要原因。我们回顾性分析了一家三级血液病医院(2012 - 2023年)收治的179例患者中的193次IYIs发作情况。酵母菌占91.7%(n = 177),而非酵母菌占8.3%(n = 16)。在侵袭性念珠菌病中,非白色念珠菌属占主导,占76.8%(136/177),白色念珠菌(36.2%,64/177)是最常分离出的菌种。在非酵母菌中,光滑念珠菌(n = 10)是最常鉴定出的病原体。IYIs的发病率和42天死亡率分别为每1000患者日0.199和0.095。42天病死率仍高达47.7%。在分类分析中,年龄>65岁、使用皮质类固醇、乳酸升高(>2 mmol/L)、中性粒细胞减少(<500/mm³)、使用血管升压药和机械通气在非幸存者中更为常见。非幸存者中原发性血流感染更频繁,而导管相关感染和腹腔源性感染在幸存者中占主导。32.6%的IYI病例(n = 63)观察到合并菌血症,大肠埃希菌是最常分离出的合并病原体。我们的研究结果表明血液病患者中IYIs的流行病学在不断演变,其特征为白色念珠菌成为主要菌种、持续的死亡率以及频繁的细菌合并感染,共同反映了IYIs巨大的临床负担。