Species distribution, antifungal susceptibility pattern and associated factors of Candida blood stream infections in Sri Lanka from 2018 to 2022.

IF 0.2 Q3 MEDICINE, GENERAL & INTERNAL

Ceylon Medical Journal Pub Date : 2024-09-19 DOI:10.4038/cmj.v69iSI3.9968

P G R Udari M Welagedara, Primali I Jayasekera

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引用次数: 0

Abstract

Introduction: Candidemia can be life-threatening in immunocompromised individuals thus, prompt diag-nosis and treatment with antifungal agents is mandatory for successful outcome. Surveillance data on species distribution, antifungal susceptibility and associated factors of candidemia is utmost important to decide on empiric antifungal therapy, to impose infection control measures as well to promote antifungal stewardship in a country. Therefore, this study was aimed at retrospective review of data on candidemia at Mycology Reference Laboratory in Sri Lanka for 5 years duration to identify the species causing candidemia, their antifungal susceptibility pattern and associated factors.

Results: A twofold rise in candidemia cases were seen during this 5-year duration compared to previous 7 years (2011-2017). Predominant species causing candidemia was C. tropicalis (35%) followed by C. parapsilosis (33%). C. albicans was the 3rd commonest species causing candidemia in Sri Lanka. There were 3% C. glabrata cases, 2% C. guilliermondii and 1% C. famata and C. krusei cases. Importantly two sequencing confirmed C. auris cases were identified for the first time in Sri Lanka in 2021. Overall good antifungal susceptibility was seen for both fluconazole and amphotericin B and there were only 7%and 1.6% resistance respectively. Long term hospital stay (47%) was commonly seen in this study group followed by use of broad-spectrum antibiotics (24%) and involvement of gastro-intestinal tract (21%).

Conclusion: Candida tropicalis is the commonest species causing candidemia in Sri Lanka. Common Candida species had good susceptibility to antifungals. Long term hospital stay was associated with candidemia in majority of patients.

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2018 - 2022年斯里兰卡念珠菌血流感染的种类分布、药敏模式及相关因素

念珠菌在免疫功能低下的个体中可能危及生命，因此，及时诊断和使用抗真菌药物治疗是成功治疗的必要条件。念珠菌的种类分布、抗真菌敏感性和相关因素的监测数据对于决定经验性抗真菌治疗、实施感染控制措施以及促进一国的抗真菌管理至关重要。因此，本研究旨在对斯里兰卡真菌学参考实验室5年的念珠菌病资料进行回顾性分析，以确定引起念珠菌病的菌种、其抗真菌药敏模式及相关因素。结果：与前7年（2011-2017年）相比，这5年期间念珠菌病例增加了两倍。引起念珠菌病的优势菌种为热带假丝酵母（35%），其次为副假丝酵母（33%）。白色念珠菌是斯里兰卡引起念珠菌病的第三常见菌种。有3% c glabrata情况下,c . c . famata guilliermondii和1%和2% c krusei病例。重要的是，2021年在斯里兰卡首次发现了两例经测序确认的耳球菌病例。氟康唑和两性霉素B对真菌的总体敏感性较好，耐药率分别为7%和1.6%。长期住院（47%）在该研究组中很常见，其次是使用广谱抗生素（24%）和累及胃肠道（21%）。结论：热带念珠菌是斯里兰卡最常见的念珠菌。普通念珠菌对抗真菌药物有良好的敏感性。在大多数患者中，长期住院与念珠菌有关。

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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Ceylon Medical Journal MEDICINE, GENERAL & INTERNAL-

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期刊介绍： The Ceylon Medical Journal, is the oldest surviving medical journal in Australasia. It is the only medical journal in Sri Lanka that is listed in the Index Medicus. The CMJ started life way back in 1887 as the organ of the Ceylon Branch of the British Medical Association. Except for a brief period between 1893 and 1904 when it ceased publication, the CMJ or its forbear, the Journal of the Ceylon Branch of the British Medical Association, has been published without interruption up to now. The journal"s name changed to the CMJ in 1954.