P290 Public health treatment due to rise in Candida auris candidemia infection

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Rakesh Singh
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引用次数: 0

Abstract

Abstract Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Introduction Isolation of Candida spp. from a blood sample in patients is known as candidemia. Candida albicans is the most common causative agent of candidemia globally while C. tropicalis is the most common causative agent in India. Candida parapsilosis complex, C. glabrata, and C. krusei are the other three common causative agents of candidemia. Candida auris was described in 2009 and is a public health treatment. It is multidrug-resistant and causes localized hospital outbreaks. Objective To determine the fungal profile of candidemia in a tertiary care hospital. Methods Institute ethics approval was taken. All patients admitted to the Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India from January 2020 to January 2021, whose blood culture samples yielded yeast were included in the study. The patient's demographic details were recorded. Yeast isolates were identified by Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS) as per the manufacture's instruction. The antifungal susceptibility testing (AFST) was performed by microbroth dilution method for fluconazole, voriconazole, amphotericin B, and caspofungin as per Clinical and Laboratory Standards Institute (CLSI) M27 and interpreted by CLSI M59 and M60 document. AFST of C. auris was interpreted as per Centers for Disease Control and Prevention (CDC) criteria. Results were expressed in percentages. Results A total of 248 blood culture samples yielded yeast cells during the study period. Approximately 63% of samples were obtained from male patients, while ∼37% were obtained from female patients. Most of the patients were between 41 to 60 years or under 10 years of age. A total of 52/240 (15.8%) were diabetic, and 30 (15.2%) were positive for severe acute respiratory syndrome coronavirus 2 (Sars-CoV-2). Candida tropicalis (34.7%) was the most common causative agent. It was followed by C. parapsilosis complex (20.2%). Candida auris (16.5%), C. albicans (13.3%), C. glabrata (6.5%), and other C. spp. (8.9%). Candida krusei is no longer observed as one of the top five agents of candidemia and it is replaced by C. auris. The rise of candidemia due to C. auris is a cause of concern, and its prevalence is observed more than that of C. albicans in our tertiary care hospital. The antifungal resistant pattern of the top four candidemia isolates is depicted in Figure 1. The antifungal resistance was maximum in C. auris isolates, followed by C. parapsilosis complex isolates. A total of 12.2% of C. auris isolates were resistant to amphotericin B, and azoles and 4.9% of C. auris isolates were multidrug-resistant. Conclusion Candida tropicalis was the most common causative agent of candidemia. But the increased prevalence of C. auris over C. albicans is a cause of concern as 4.9% of C. auris isolates were multidrug-resistant.
P290由于耳念珠菌感染上升的公共卫生治疗
摘要:2022年9月22日,下午12:30 - 1:30介绍从患者血液样本中分离念珠菌被称为念珠菌。白色念珠菌是全球念珠菌最常见的病原体,而热带念珠菌是印度最常见的病原体。假丝酵母菌复合体、光滑假丝酵母菌和克鲁假丝酵母菌是假丝酵母菌的另外三种常见病原体。耳念珠菌于2009年被发现,是一种公共卫生治疗方法。它具有多重耐药性,并引起局部医院暴发。目的了解某三级医院念珠菌感染情况。方法采用研究所伦理审批。2020年1月至2021年1月,印度普杜切里贾瓦哈拉尔研究生医学教育与研究所(JIPMER)收治的所有患者,其血液培养样本产生酵母都被纳入研究。记录了患者的人口统计细节。根据制造商的说明,采用基质辅助激光解吸/电离飞行时间质谱法(MALDI-TOF MS)鉴定酵母菌分离物。采用微量肉汤稀释法对氟康唑、伏立康唑、两性霉素B和卡泊芬净进行抗真菌药敏试验(AFST),试验方法参照美国临床与实验室标准协会(CLSI) M27,并按照CLSI M59和M60文件进行解释。金黄色葡萄球菌的AFST被解释为按照疾病控制和预防中心(CDC)的标准。结果以百分数表示。结果在研究期间,共有248份血培养样本产生酵母细胞。大约63%的样本来自男性患者,而约37%的样本来自女性患者。大多数患者年龄在41 ~ 60岁之间或10岁以下。其中糖尿病患者52/240人(15.8%),严重急性呼吸综合征冠状病毒2型(Sars-CoV-2)阳性30人(15.2%)。热带假丝酵母(34.7%)是最常见的病原体。其次是假丝孢杆菌复合体(20.2%)。耳念珠菌(16.5%)、白色念珠菌(13.3%)、光滑念珠菌(6.5%)和其他念珠菌(8.9%)。克鲁氏念珠菌已不再是念珠菌的前五大病原体之一,取而代之的是金黄色念珠菌。由于耳念珠菌引起的念珠菌病的上升是一个值得关注的问题,在我们三级保健医院,其患病率高于白色念珠菌。图1描述了前四种念珠菌分离株的抗真菌耐药性模式。金黄色葡萄球菌的抗真菌能力最强,其次是复合葡萄球菌。对两性霉素B耐药的金黄色葡萄球菌占12.2%,对唑类和4.9%的金黄色葡萄球菌为多药耐药。结论热带念珠菌是念珠菌病最常见的病原体。但是,金黄色念珠菌的流行率高于白色念珠菌,这是一个值得关注的问题,因为4.9%的金黄色念珠菌分离株具有多重耐药。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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