沙特阿拉伯西部地区一家三级医院的毛丝虫病种血流感染:2016 - 2022年7年回顾性图表回顾

IF 2.7 3区 医学 Q3 INFECTIOUS DISEASES
Hassan Almarhabi, Aisha Alharbi, Raghad Alfagi, Abdulfattah Al-Amri
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引用次数: 0

摘要

尽管医学真菌学取得了进展,但侵袭性毛丝虫病感染仍然与高死亡率有关。关于毛丝虫病的危险因素和结果的数据有限,特别是在我们地区。因此,本研究的目的是描述危险因素,患者的特点,抗真菌敏感性,并在沙特阿拉伯三级保健医院的血滴虫感染的结局。这是一项单中心回顾性图表综述,纳入了2016年1月至2022年12月血培养阳性的≥16岁的Trichosporon sp成人患者。描述性统计使用连续变量的平均值和分类变量的数量(百分比)来表示。从血培养中分离的10例Trichosporon sp患者符合纳入本研究的条件。平均年龄58.1岁(17-83岁),男性占70%。此外,40%有糖尿病,40%有潜在的恶性肿瘤。在90%的分离株中,朝日毛孢菌为优势菌种。所有患者近期均使用广谱抗生素,80%暴露于皮质类固醇,所有患者均使用中心静脉导管。一例肾移植患者早期复发了毛孢真菌病。4例感染治愈,2例采用伏立康唑单药治疗,2例采用两性霉素B脂质体联合伏立康唑治疗。30天全因死亡率为60%,其中3例死亡发生在鉴定分离株之前。总之,我们的研究报告了朝日毛磷菌的优势,在毛磷菌菌血症患者中死亡率为60%。挑战包括延迟诊断、高死亡率和抗真菌药物耐药性,强调需要进一步研究以加强治疗策略和患者预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Trichosporon species bloodstream infections in a tertiary care hospital in the western region of Saudi Arabia: A 7-year retrospective chart review from 2016 to 2022.

Despite advances in medical mycology, invasive Trichosporon spp. infections continue to be associated with high mortality rates. Limited data exist on the risk factors and outcomes of Trichosporon fungemia, particularly in our region. Therefore, this study aims to describe the risk factors, patient characteristics, antifungal susceptibility, and outcome of Trichosporon bloodstream infections at a tertiary care hospital in Saudi Arabia. This was a single-center retrospective chart review that included adult patients ≥ 16 years with positive blood cultures for Trichosporon spp. from January 2016 to December 2022. Descriptive statistics are presented using the mean for continuous variables and the number (percentage) for categorical variables. Ten patients with Trichosporon spp. isolated from blood cultures were eligible for inclusion in this study. The mean age was 58.1 years (range 17-83), with 70% male patients. Additionally, 40% had diabetes mellitus, and 40% had underlying malignancy. Trichosporon asahii was the predominant species in 90% of isolates. All patients had recent broad-spectrum antibiotic use, 80% were exposed to corticosteroids, and all had central venous catheters. One kidney transplant had an early recurrence of Trichosporon spp. fungemia. Four patients were cured of the infection, two were treated with voriconazole monotherapy, and two were treated with a combination of liposomal amphotericin B plus Voriconazole. Thirty-day all-cause mortality was 60%, with three deaths occurring before identification of the isolates. In conclusion, our study reported a predominance of Trichosporon asahii and a mortality rate of 60% in patients with Trichosporon fungemia. Challenges include delayed diagnosis, high mortality, and antifungal resistance, underscoring the need for further research to enhance treatment strategies and patient outcomes.

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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.
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