Increasing incidence of candidaemia: long-term epidemiological trends, Queensland, Australia, 1999-2008
Increasing incidence of candidaemia: long-term epidemiological trends, Queensland, Australia, 1999-2008
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DOI：
10.1016/j.jhin.2010.01.022
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发表时间：
2010-09-01
影响因子：
6.9
通讯作者：
Sorrell, T. C.
中科院分区：
文献类型：
--
作者：
Playford, E. G.;Nimmo, G. R.;Sorrell, T. C.
鉴于念珠菌血症流行病学的变异性和当代纵向数据的相对缺乏，进行了一项基于实验室的被动监测研究，以评估 1999 年至 2008 年期间澳大利亚昆士兰州所有公共医疗机构的念珠菌血症流行病学。从实验室和管理信息系统收集所有念珠菌血症发作的人口统计和微生物学数据以及适当的分母（入院人数和患者天数）。从 1999 年到 2008 年，发生了 1137 次发作（总体发病密度：每 10 000 患者日 0.45 次），密度增加了 3.5 倍（趋势 P < 0.0001）。源自传统高风险地区的念珠菌血症发作要么减少（血液肿瘤科和儿科病房），要么保持稳定（重症监护病房）。随着时间的推移，成人内科/外科病房的发病率明显增加，到2008年占总数的60%。白色念珠菌引起的相对比例下降，近平滑念珠菌引起的相对比例上升（均P < 0.01）。氟康唑耐药菌株的比例没有变化。传统高风险地区之外念珠菌血症的发生率不断增加以及近平滑念珠菌的出现给预防和早期干预策略带来了新的挑战。 (C) 2010 年医院感染协会。由爱思唯尔有限公司出版。保留所有权利。
Given variability in the epidemiology of candidaemia and a relative paucity of contemporary longitudinal data, a passive laboratory-based surveillance study was performed to assess the epidemiology of candidaemia in all public healthcare facilities in Queensland, Australia over the period 1999-2008. Demographic and microbiological data on all candidaemia episodes, together with appropriate denominators (admissions and patient-days), were collected from laboratory and administrative information systems. From 1999 to 2008, 1137 episodes occurred (overall incidence-density: 0.45 per 10 000 patient-days) with a 3.5-fold increase in density (P < 0.0001 for trend). Candidaemia episodes originating in traditional high-risk areas either decreased (haemato-oncology and paediatric wards) or remained stable (intensive care units). Episodes on adult medical/surgical wards increased significantly over time, accounting for 60% of the total by 2008. The relative proportion caused by Candida albicans decreased and Candida parapsilosis increased (both P < 0.01). The proportion of fluconazole-resistant isolates did not change. The increasing occurrence of candidaemia outside traditional high-risk areas and the emergence of C. parapsilosis present new challenges for preventive and early intervention strategies. (C) 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.