Five-year profile of candidaemia at an Indian trauma centre: High rates of Candida auris blood stream infections
Five-year profile of candidaemia at an Indian trauma centre: High rates of Candida auris blood stream infections
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DOI：
10.1111/myc.12790
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发表时间：
2018-09-01
期刊：
影响因子：
4.9
通讯作者：
Chowdhary, Anuradha
中科院分区：
文献类型：
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作者：
Mathur, Purva;Hasan, Fahmi;Chowdhary, Anuradha
念珠菌血症是一种潜在的致命性感染，具有不同的念珠菌种类分布和对真菌的敏感性。最近在侵袭性念珠菌病中出现的金黄色念珠菌是一个令人担忧的原因。这项研究描述了印度一家三级保健医院的念珠菌血症情况，并报告了金黄色念珠菌的出现。对2012至2017年间所有被诊断为念珠菌血症的患者进行了研究。用常规方法VITEK 2和MALDI-TOF MS对分离株进行鉴定，未经MALDI-TOF鉴定的菌株进行测序。用CLSI肉汤微量稀释法和VITEK-2药敏试验对114株念珠菌进行药敏试验。热带假丝酵母菌占39.4%，其次是金黄色念珠菌(17.5%)、白色念珠菌(14%)和近缘念珠菌(11.4%)。值得注意的是，未经MALDI-TOF鉴定并经测序证实的是10株中美金藻分离物。此外，45%(n=9)的金黄色葡萄球菌对流感的MIC值较低(0.05-4g/m L)，其余55%(n=11)的菌株对流感的MICs较高(64 g/m L)。2株中美葡萄球菌对流感的最低抑菌浓度为32g/m L。与CLSI方法相比，VITEK 2的抗真菌敏感性错误率较高。金黄色念珠菌是引起念珠菌血症的第二大流行物种，有必要加强感染控制措施，以防止其蔓延。
Candidaemia is a potentially fatal infection with varied distribution of Candida species and their antifungal susceptibility profiles. The recent emergence of Candida auris in invasive candidiasis is a cause for concern. This study describes the profile of candidaemia at an Indian tertiary care hospital and reports the emergence of C.auris. All patients diagnosed with candidaemia between 2012 and 2017 were studied. The isolates were identified using conventional methods, VITEK 2 and MALDI-TOF MS. The isolates not identified by MALDI-TOF were sequenced. Antifungal susceptibility testing was done by the CLSI broth microdilution method and VITEK 2. Atotal of 114 isolates of Candida species were analysed. Candida tropicalis (39.4%) was the most common species, followed by C.auris (17.5%), C.albicans (14%) and C.parapsilosis (11.4%). Notably, Diutina mesorugosa isolates (n=10) were not identified by MALDI-TOF and were confirmed by sequencing. Furthermore, 45% (n=9) C.auris strains exhibited low MICs of FLU (0.05-4g/mL) and the remaining 55% (n=11) isolates had high MICs64g/mL. Also, D.mesorugosa exhibited high MICs of FLU (32g/mL) in 2 isolates. A high rate of errors in antifungal susceptibility was noted with the VITEK 2 as compared to the CLSI method. Candida auris was the second most prevalent species causing candidaemia warranting infection control practices to be strengthened to prevent its spread.