Species-specific risk of ophthalmic involvement in candidaemia: a propensity-matched competing risk analysis.

IF 10.9 1区医学 Q1 INFECTIOUS DISEASES

Clinical Microbiology and Infection Pub Date : 2025-06-07 DOI:10.1016/j.cmi.2025.06.002

Sung-Woon Kang, SolAh Han, Geonui Kim, Hyo-Ju Son, Eun Jeong Won, Heungsup Sung, Mi-Na Kim, Euijin Chang, Seongman Bae, Jiwon Jung, Min Jae Kim, Sung-Han Kim, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Joo Yong Lee, Yong Pil Chong

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引用次数: 0

Abstract

Objectives: Given the limited data on species-specific ocular involvement in candidaemia, we aimed to assess the differential risk of ocular involvement according to Candida species in patients with candidaemia.

Methods: A retrospective review was conducted of patients with candidaemia who underwent funduscopic examination at a tertiary centre in Seoul, Republic of Korea between January 2014 and December 2023. Ocular involvement, defined as endophthalmitis, was determined by two retinal specialists. Propensity score matching and competing risk analyses were performed to adjust for pre-specified risk factors and mitigate competing risk bias.

Results: A total of 674 patients with candidaemia were included. Endophthalmitis was identified in 5% (32/674), and probable chorioretinitis in 10% (67/674). The prevalence of endophthalmitis was relatively high in Candida albicans (16/245, 7%) and C. tropicalis (13/126, 10%), but low in C. glabrata (0/193), C. parapsilosis (2/68, 3%), and C. krusei (0/19). Competing risk analysis identified C. albicans or C. tropicalis infection (subdistribution hazard ratio [sHR] 7.90, 95% CI: 2.42-25.75) as an independent risk factor for endophthalmitis. In propensity score-matched analyses, C. albicans (sHR 5.85, 95% CI: 1.71-19.95) and C. tropicalis (sHR 6.97, 95% CI: 1.58-29.85) were each significantly more associated with ocular involvement than non-albicans and non-tropicalis species.

Discussion: Although ophthalmic examinations are already recommended in all candidaemia cases, our findings underscore their particular importance in C. albicans and C. tropicalis infections, where ocular involvement is significantly more common than in those involving other Candida species.

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念珠菌感染眼科的物种特异性风险：倾向匹配的竞争风险分析。

考虑到念珠菌种类特异性眼部受累的数据有限，我们的目的是评估念珠菌种类不同患者眼部受累的差异风险。方法：回顾性分析2014年1月至2023年12月在韩国首尔某三级医疗中心接受眼底检查的念珠菌病患者。眼部受累，定义为眼内炎，由两位视网膜专家确定。进行倾向得分匹配和竞争风险分析，以调整预先指定的风险因素和减轻竞争风险偏差。结果：共纳入念珠菌病患者674例。5%（32/674）诊断为眼内炎，10%（67/674）诊断为可能的绒毛膜视网膜炎。眼内炎在白色念珠菌（16/ 245,7%）和热带念珠菌（13/ 126,10%）中患病率较高，而在光秃念珠菌（0/193）、假丝珠菌（2/ 68,3%）和克鲁氏念珠菌（0/19）中患病率较低。竞争风险分析发现白色梭菌或热带梭菌感染（亚分布风险比[sHR] 7.90, 95%可信区间[CI] 2.42-25.75）是眼内炎的独立危险因素。在倾向评分匹配分析中，白色念珠菌（sHR 5.85, 95% CI 1.71-19.95）和热带念珠菌（sHR 6.97, 95% CI 1.58-29.85）与眼部累及的相关性均显著高于非白色念珠菌和非热带念珠菌。结论：虽然在所有念珠菌病例中都建议进行眼科检查，但我们的研究结果强调了眼科检查对白色念珠菌和热带念珠菌感染的特别重要性，这两种念珠菌的眼部受累明显比其他念珠菌更常见。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Microbiology and Infection 医学-传染病学

CiteScore

25.30

自引率

2.10%

发文量

441

审稿时长

2-4 weeks

期刊介绍： Clinical Microbiology and Infection (CMI) is a monthly journal published by the European Society of Clinical Microbiology and Infectious Diseases. It focuses on peer-reviewed papers covering basic and applied research in microbiology, infectious diseases, virology, parasitology, immunology, and epidemiology as they relate to therapy and diagnostics.