Candidemia epidemiology and susceptibility profile in the largest Brazilian teaching hospital complex
Candidemia epidemiology and susceptibility profile in the largest Brazilian teaching hospital complex
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DOI：
10.1590/s1413-86702010000500004
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发表时间：
2010-10-01
影响因子：
3.4
通讯作者：
Rossi, Flávia
中科院分区：
文献类型：
--
作者：
Motta, Adriana Lopes;Almeida, Gisele Madeira Duboc de;Rossi, Flávia
导语：虽然引起血流真菌感染的真菌种类在不断扩大，但念珠菌仍然是这些病例的主要原因。目的：了解巴西某公立三级教学医院2500张床位念珠菌的流行病学、菌种分布及药敏特征。方法：利用2006年微生物学实验室记录对血培养阳性患者进行鉴定。采用Etest法测定两性霉素B、卡泊真菌素、伊曲康唑、氟康唑、伏立唑和泊沙康唑的体外活性。结果：检出念珠菌136例，可进行药敏试验的菌株100株。念珠菌病的总发病率为1.87例/ 1000人次，0.27例/ 1000患者日。患者中男性占58.1%，中位年龄40岁。以白色念珠菌最多（52.2%），其次为副枯枝念珠菌（22.1%）、热带念珠菌（14.8%）和光秃念珠菌（6.6%）。所有菌株均对两性霉素B敏感，MIC90为0.5 μ g/mL。伏立康唑、氟康唑和卡泊芬净的总敏感性为>= 97%，MIC90分别为0.064、4.0和1.0 μ g/mL。对伊曲康唑的敏感性为81%，MIC90为0.5 μ g/mL。泊沙康唑也表现出良好的体外活性，MIC90为0.25 μ g/mL。结论：本报告为我院首次报道的抗真菌药敏病例。
Introduction: Although the spectrum of fungi causing bloodstream fungal infections continues to expand, Candida spp. remains responsible for the majority of these cases. Objective: The purpose of this study was to characterize the candidemia epidemiology, species distribution and antifungal susceptibility patterns at a Brazilian tertiary teaching public hospital with 2,500 beds. Methods: Records from the microbiology laboratory were used to identify patients with positive blood cultures during 2006. The in vitro activity of amphotericin B, caspofungin, itraconazole, fluconazole, voricanozole, and posaconazole were determined using the Etest method. Results: One hundred and thirty-six cases of candidemia were identified and 100 strains were available for antifungal susceptibility testing. The overall incidence of candidemia was 1.87 cases/1.000 admissions and 0.27 cases/1.000 patient-days. Among the patients, 58.1% were male, and the median age was 40 years old. C. albicans was the most common species (52.2%), followed by C. parapsilosis (22.1%), C. tropicalis (14.8%), and C. glabrata (6.6%). All strains were susceptible to amphotericin B with a MIC90 of 0.5 mu g/mL. Overall susceptibility for voriconozole, fluconazole, and caspofungin was >= 97% with a MIC90 of 0.064, 4.0 and 1.0 mu g/mL, respectively. For itraconazole the susceptibility rate was 81% with a MIC90 of 0.5 mu g/mL. Posaconazole also demonstrated good in vitro activity with a MIC90 of 0.25 mu g/mL. Conclusion: This is the first antifungal susceptibility report in our institution.