巴西念珠菌病系统回顾:揭示历史趋势和在中等收入国家开展调查所面临的挑战》。

IF 3.6 3区 生物学 Q2 MYCOLOGY
Flávio Guinsburg Hamburger, Ana Cristina Gales, Arnaldo Lopes Colombo
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引用次数: 0

摘要

导言:念珠菌血症是一种主要影响危重病人的血流感染,对全球健康构成重大威胁,尤其是随着包括耐药菌株在内的非厌氧菌念珠菌的出现。在巴西,先进的诊断工具和训练有素的微生物学家有限,妨碍了念珠菌种类的准确鉴定和抗真菌药物敏感性测试,阻碍了监测工作:我们对2017年至2023年期间有关巴西念珠菌血症患者中念珠菌种类分布和抗真菌药物敏感性的出版物进行了系统回顾:尽管最初确定了 7075 条记录,但只有 16 条符合纳入标准,提供了 2305 例念珠菌血症的准确信息。主要菌种是白念珠菌、副丝状念珠菌和热带念珠菌,其次是明显比例的光滑中生酵母菌。在 16 项关于念珠菌病的研究中,只有 5 项能够报告抗真菌药敏试验的结果,可见诊断性试验的普及程度有限。对棘白菌素的体外抗药性非常罕见(只有 6/396 个分离株,占 1.5%)。与此相对应,氟康唑的耐药率从 0% 到 43% 不等,不同的研究和所考虑的念珠菌种类之间存在很大的异质性:我们的综述强调,巴西亟需加强监测和研究工作,以应对不断变化的念珠菌血症和抗真菌耐药性问题。尽管存在一些局限性,但现有数据表明,虽然对棘白菌素类和两性霉素 B 的耐药性仍然罕见,但念珠菌对氟康唑的耐药性却日益令人担忧。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Systematic Review of Candidemia in Brazil: Unlocking Historical Trends and Challenges in Conducting Surveys in Middle-Income Countries.

Systematic Review of Candidemia in Brazil: Unlocking Historical Trends and Challenges in Conducting Surveys in Middle-Income Countries.

Introduction: Candidemia, a bloodstream infection predominantly affecting critically ill patients, poses a significant global health threat especially with the emergence of non-albicans Candida species, including drug-resistant strains. In Brazil, limited access to advanced diagnostic tools and trained microbiologists hampers accurate identification of Candida species and susceptibility to antifungals testing hindering surveillance efforts.

Methods: We conducted a systematic review spanning publications from 2017 to 2023 addressing Candida species distribution and antifungal susceptibility among Brazilian patients with candidemia.

Results: Despite initially identifying 7075 records, only 16 met inclusion criteria providing accurate information of 2305 episodes of candidemia. The predominant species were C. albicans, C. parapsilosis, and C. tropicalis, followed by notable proportions of Nakaseomyces glabratus. Limited access to diagnostic tests was evident as only 5 out of 16 studies on candidemia were able to report antifungal susceptibility testing results. In vitro resistance to echinocandins was rare (only 6/396 isolates, 1,5%). In counterpart, fluconazole exhibited resistance rates ranging from 0 to 43%, with great heterogeneity among different studies and species of Candida considered.

Conclusion: Our review underscores the critical need for enhanced surveillance and research efforts to address the evolving landscape of candidemia and antifungal resistance in Brazil. Despite some limitations, available data suggest that while resistance to echinocandins and amphotericin B remains rare, there is a growing concern regarding resistance to fluconazole among Candida species.

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来源期刊
Mycopathologia
Mycopathologia 生物-真菌学
CiteScore
6.80
自引率
3.60%
发文量
76
审稿时长
3 months
期刊介绍: Mycopathologia is an official journal of the International Union of Microbiological Societies (IUMS). Mycopathologia was founded in 1938 with the mission to ‘diffuse the understanding of fungal diseases in man and animals among mycologists’. Many of the milestones discoveries in the field of medical mycology have been communicated through the pages of this journal. Mycopathologia covers a diverse, interdisciplinary range of topics that is unique in breadth and depth. The journal publishes peer-reviewed, original articles highlighting important developments concerning medically important fungi and fungal diseases. The journal highlights important developments in fungal systematics and taxonomy, laboratory diagnosis of fungal infections, antifungal drugs, clinical presentation and treatment, and epidemiology of fungal diseases globally. Timely opinion articles, mini-reviews, and other communications are usually invited at the discretion of the editorial board. Unique case reports highlighting unprecedented progress in the diagnosis and treatment of fungal infections, are published in every issue of the journal. MycopathologiaIMAGE is another regular feature for a brief clinical report of potential interest to a mixed audience of physicians and laboratory scientists. MycopathologiaGENOME is designed for the rapid publication of new genomes of human and animal pathogenic fungi using a checklist-based, standardized format.
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