Epidemiologic Shift in Candidemia Driven by Candida auris, South Africa, 2016-2017
Epidemiologic Shift in Candidemia Driven by Candida auris, South Africa, 2016-2017
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DOI：
10.3201/eid2509.190040
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发表时间：
2019-09-01
影响因子：
11.8
通讯作者：
Shilubane, Amanda
中科院分区：
文献类型：
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作者：
van Schalkwyk, Erika;Mpembe, Ruth S.;Shilubane, Amanda
耳念珠菌是一种侵袭性的卫生保健相关真菌病原体。2016-2017年期间，南非通过国家实验室监测发现了念珠菌病病例，念珠菌病被定义为从血液中培养念珠菌的患者的疾病。我们通过质谱和测序鉴定了活菌。269家医院6669例病例（有种属鉴定的5876例）中，794例（14%）由金黄色葡萄球菌引起。133家医院所有念珠菌的发病率风险为83.8例/10万例（95% CI 81.2-86.4）。与其他念珠菌引起的血液感染相比，先前的全身抗真菌药物治疗与耳念珠菌真菌血症的校正几率增加40%相关（校正优势比为1.4 [95% CI 0.8-2.3]）。粗住院病死率在不同念珠菌种类之间没有差异，耳念珠菌为45%，而非念珠菌为43%。奥瑞丝candidemia。锥虫引起了南非念珠菌病的重大流行病学转变。
Candida auris is an invasive healthcare-associated fungal pathogen. Cases of candidemia, defined as illness in patients with Candida cultured from blood, were detected through national laboratory-based surveillance in South Africa during 2016-2017. We identified viable isolates by using mass spectrometry and sequencing. Among 6,669 cases (5,876 with species identification) from 269 hospitals, 794 (14%) were caused by C. auris. The incidence risk for all candidemia at 133 hospitals was 83.8 (95% CI 81.2-86.4) cases/100,000 admissions. Prior systemic antifungal drug therapy was associated with a 40% increased adjusted odds of C. auris fungemia compared with bloodstream infection caused by other Candida species (adjusted odds ratio 1.4 [95% CI 0.8-2.3]). The crude in-hospital case-fatality ratio did not differ between Candida species and was 45% for C. auris candidemia, compared with 43% for non-C. auris candidemia. C. awls has caused a major epidemiologic shift in candidemia in South Africa.