Epidemiology and outcomes of Candida-associated osteoarticular infections: A multicentre retrospective study from Turkey.

IF 2.3 3区 医学 Q3 INFECTIOUS DISEASES
Özlem Güler, Murat Üzel, Dilşat Tepe, Firdevs Aksoy, Güle Çınar, Kemal Osman Memikoğlu, Bülent Durdu, Tülay Ünver Ulusoy, Aysun Benli̇, Zeynep Karakaşoğlu, Neşe Saltoğlu, Derya Seyman, Işıl Deniz Alıravcı, Hasibullah Yaqoobi, Ayça Aydın, Hatun Öztürk Çerik, Selin Özdemir, Betül Sümer, Azize Yetişgen, Ayşe Batırel, Ayşe Serra Özel, Seniha Şenbayrak, Yasemin Tezer Tekçe, Zehra Çağla Karakoç
{"title":"Epidemiology and outcomes of Candida-associated osteoarticular infections: A multicentre retrospective study from Turkey.","authors":"Özlem Güler, Murat Üzel, Dilşat Tepe, Firdevs Aksoy, Güle Çınar, Kemal Osman Memikoğlu, Bülent Durdu, Tülay Ünver Ulusoy, Aysun Benli̇, Zeynep Karakaşoğlu, Neşe Saltoğlu, Derya Seyman, Işıl Deniz Alıravcı, Hasibullah Yaqoobi, Ayça Aydın, Hatun Öztürk Çerik, Selin Özdemir, Betül Sümer, Azize Yetişgen, Ayşe Batırel, Ayşe Serra Özel, Seniha Şenbayrak, Yasemin Tezer Tekçe, Zehra Çağla Karakoç","doi":"10.1093/mmy/myaf080","DOIUrl":null,"url":null,"abstract":"<p><p>This multicentre retrospective study investigated the epidemiology, clinical characteristics, and fluconazole resistance rates of Candida species in osteoarticular infections across Turkey as well as the factors influencing complete recovery. Data were gathered from 73 adult patients diagnosed with proven or probable Candida-associated osteoarticular infections between 2015 and 2025 from 20 healthcare centres. The most common clinical presentation was spondylodiscitis, followed by the involvement of phalangeal bones in the hands and feet. Non-albicansCandida species accounted for 37/73 cases (50.7%), with Candida parapsilosis being the most frequent. Fluconazole resistance was low among C. albicans isolates (3%) but higher among non-albicans yeasts (27%). Bacterial co-infection, predominantly Gram-positive bacteria, was detected in 52.1% of cases. Diabetes was present in 50/73 patients (68.5%), particularly insulin-dependent diabetes, and was a prominent comorbidity that may have also contributed as a predisposing factor. Radiological detection of osteomyelitis was achieved in 69.9% of patients. Fluconazole was the most commonly used antifungal agent (74%) with a median treatment duration of 90 days. Multivariate analysis revealed that surgical debridement was significantly associated with a higher odds of clinical recovery (adjusted odds ratio [aOR], 5.764; 95% confidence interval [CI], 1.360-24.434; P = .017), whereas diabetes mellitus was significantly associated with a lower odds of total recovery (aOR, 0.205; 95% CI, 0.053-0.792; P = .022). In conclusion, this multicentre study provides epidemiological data and fluconazole resistance rates of Candida species causing osteoarticular infections in Turkey, highlights the occurrence of C. auris in this cohort, and identifies surgical intervention and diabetes mellitus as factors significantly associated with recovery.</p>","PeriodicalId":18586,"journal":{"name":"Medical mycology","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421878/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical mycology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/mmy/myaf080","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

Abstract

This multicentre retrospective study investigated the epidemiology, clinical characteristics, and fluconazole resistance rates of Candida species in osteoarticular infections across Turkey as well as the factors influencing complete recovery. Data were gathered from 73 adult patients diagnosed with proven or probable Candida-associated osteoarticular infections between 2015 and 2025 from 20 healthcare centres. The most common clinical presentation was spondylodiscitis, followed by the involvement of phalangeal bones in the hands and feet. Non-albicansCandida species accounted for 37/73 cases (50.7%), with Candida parapsilosis being the most frequent. Fluconazole resistance was low among C. albicans isolates (3%) but higher among non-albicans yeasts (27%). Bacterial co-infection, predominantly Gram-positive bacteria, was detected in 52.1% of cases. Diabetes was present in 50/73 patients (68.5%), particularly insulin-dependent diabetes, and was a prominent comorbidity that may have also contributed as a predisposing factor. Radiological detection of osteomyelitis was achieved in 69.9% of patients. Fluconazole was the most commonly used antifungal agent (74%) with a median treatment duration of 90 days. Multivariate analysis revealed that surgical debridement was significantly associated with a higher odds of clinical recovery (adjusted odds ratio [aOR], 5.764; 95% confidence interval [CI], 1.360-24.434; P = .017), whereas diabetes mellitus was significantly associated with a lower odds of total recovery (aOR, 0.205; 95% CI, 0.053-0.792; P = .022). In conclusion, this multicentre study provides epidemiological data and fluconazole resistance rates of Candida species causing osteoarticular infections in Turkey, highlights the occurrence of C. auris in this cohort, and identifies surgical intervention and diabetes mellitus as factors significantly associated with recovery.

土耳其念珠菌相关骨关节感染的流行病学和结果:一项多中心回顾性研究。
本多中心回顾性研究调查了土耳其各地骨关节感染念珠菌的流行病学、临床特征和氟康唑耐药率,以及影响完全康复的因素。数据收集自2015年至2025年期间来自20个医疗保健中心的73名确诊或可能患有念珠菌相关骨关节感染的成年患者。最常见的临床表现是脊柱椎间盘炎,其次是手和脚的指骨受累。非白色念珠菌占37/73例(50.7%),以假丝酵母菌傍孢病最为常见。白色念珠菌分离株对氟康唑的耐药性较低(3%),而非白色念珠菌的耐药性较高(27%)。52.1%的病例检出细菌共感染,以革兰氏阳性菌为主。50/73例患者(68.5%)存在糖尿病,尤其是胰岛素依赖型糖尿病,这是一个突出的合并症,也可能是一个易感因素。骨髓炎的影像学检出率为69.9%。氟康唑是最常用的抗真菌药物(74%),中位治疗时间为90天。多因素分析显示,手术清创与较高的临床恢复率显著相关(调整优势比[aOR], 5.764; 95%可信区间[CI], 1.360-24.434; p = 0.017),而糖尿病与较低的总恢复率显著相关(aOR, 0.205; 95% CI, 0.053-0.792; p = 0.022)。总之,这项多中心研究提供了土耳其引起骨关节感染的念珠菌种类的流行病学数据和氟康唑耐药率,强调了该队列中C. auris的发生率,确定手术干预和糖尿病是与康复显著相关的因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Medical mycology
Medical mycology 医学-兽医学
CiteScore
5.70
自引率
3.40%
发文量
632
审稿时长
12 months
期刊介绍: Medical Mycology is a peer-reviewed international journal that focuses on original and innovative basic and applied studies, as well as learned reviews on all aspects of medical, veterinary and environmental mycology as related to disease. The objective is to present the highest quality scientific reports from throughout the world on divergent topics. These topics include the phylogeny of fungal pathogens, epidemiology and public health mycology themes, new approaches in the diagnosis and treatment of mycoses including clinical trials and guidelines, pharmacology and antifungal susceptibilities, changes in taxonomy, description of new or unusual fungi associated with human or animal disease, immunology of fungal infections, vaccinology for prevention of fungal infections, pathogenesis and virulence, and the molecular biology of pathogenic fungi in vitro and in vivo, including genomics, transcriptomics, metabolomics, and proteomics. Case reports are no longer accepted. In addition, studies of natural products showing inhibitory activity against pathogenic fungi are not accepted without chemical characterization and identification of the compounds responsible for the inhibitory activity.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信