西班牙医院的真菌病:假丝酵母菌在15年期间的作用。

Mar Martí-Carrizosa, Ferran Sánchez-Reus, Francesca March, Pere Coll
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引用次数: 17

摘要

背景:假丝酵母菌病是三级医院真菌血症的主要原因之一。很少有研究分析其长期分布的变化。我们比较了C. parapsilosis分布与其他真菌在一个三级医院超过15年的时间。方法:采用新的菌种特异性临床断点对拟裂丝虫的易感性进行分析。对拟南芥复合体进行了分子分化。结果:1997年1月至2011年12月,共分离真菌病360株,350例。第二常被分离的种为parapsilosis (20%);仅发现1例直骨弧菌,未发现转骨弧菌。其余病原菌分别为白色念珠菌(43.1%)、热带念珠菌(14.4%)、光秃念珠菌(11.7%)和其他真菌(10.8%)。从2009年到2011年,念珠菌病的发病率增加了两倍多(从3.3例/10万人增加到7.4例/10万人),在此期间,假丝酵母菌病和光秃秃假丝酵母菌病也有所增加。15岁以下儿童多见,占57.1%。对阿尼杜冯宁、米卡冯宁、氟胞嘧啶、两性霉素B、泊沙康唑敏感的分离株占98.5%,对伏立康唑敏感的占97.1%,对氟康唑敏感的占95.6%,对伊曲康唑敏感的占76.5%。结论:这项长期研究显示,在研究期间念珠菌的发病率略有增加,并且有增加假丝胞菌的趋势。由于其发病率高,对棘球珠菌素的易感性低,应监测其患病率和易感性,特别是在儿童中。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Fungemia in a Spanish hospital: the role of Candida parapsilosis over a 15-year period.

Background: Candida parapsilosis is one of the main causes of fungemia in tertiary-care hospitals. Few studies have analysed the changes in its distribution over a long period. We compared the distribution of C. parapsilosis with that of other fungi over a 15-y period in a tertiary hospital.

Methods: The susceptibility of C. parapsilosis was analysed using the new species-specific clinical breakpoints. The C. parapsilosis complex species were differentiated molecularly.

Results: From January 1997 to December 2011, 360 isolates causing 350 episodes of fungemia were isolated. C. parapsilosis was the second most frequently isolated species (20%); only 1 C. orthopsilosis was identified and there were no C. metapsilosis. The remaining episodes were caused by C. albicans (43.1%), C. tropicalis (14.4%), C. glabrata (11.7%), and other fungal species (10.8%). The incidence of candidemia increased more than two-fold between 2009 and 2011 (from 3.3 to 7.4 cases/100,000 population), and C. parapsilosis and C. glabrata fungemia increased throughout the period. C. parapsilosis was the most frequent species in children under 15 y (57.1%). All C. parapsilosis isolates were susceptible to anidulafungin, micafungin, flucytosine, amphotericin B, and posaconazole, while 98.5% were susceptible to caspofungin, 97.1% to voriconazole, 95.6% to fluconazole, and 76.5% to itraconazole.

Conclusions: This long-term study showed a slight increase in the incidence of candidemia during the years of the study and a trend towards an increase in C. parapsilosis. Because of its high frequency and intrinsic low susceptibility to echinocandins, the prevalence and susceptibility of C. parapsilosis should be monitored, especially in children.

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