Hospital Laboratory Survey for Identification of Candida auris in Belgium
Hospital Laboratory Survey for Identification of Candida auris in Belgium
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DOI：
10.3390/jof5030084
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发表时间：
2019-09-01
期刊：
影响因子：
4.7
通讯作者：
Vernelen, Kris
中科院分区：
文献类型：
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作者：
Dewaele, Klaas;Lagrou, Katrien;Vernelen, Kris
耳念珠菌是一种难以识别的新兴酵母菌，也是医院内持续爆发的原因。目前，关于欧洲实验室准备情况的数据并不多。为了评估比利时和卢森堡实验室检测该物种的能力，比利时公共卫生机构 Sciensano 组织的定期能力测试轮中纳入了盲念珠菌菌株。实验室被要求像在常规临床实践中那样识别和报告分离株，就像从血培养物中生长一样。在 142 名受访者中，82 名（57.7%）获得了耳念珠菌的正确鉴定。在 142 名受访者中，27 名 (19.0%) 确认该菌株为血念珠菌 (Candida haemulonii)。其余未获得正确鉴定的实验室（33/142，23.2%）、报告了其他酵母物种（4/33）或未能获得物种鉴定（29/33）。为了评估对识别的感染控制影响的认识，要求参与者指出在临床背景下是否需要将该分离株转介到参考实验室。超过三分之一的受访者（54/142，38.0%）表示，他们不会将分离株送到参考实验室，无论是出于流行病学原因，还是为了鉴定确认或抗真菌药敏测试。这占提交耳念珠菌鉴定结果的实验室的 41.5% (34/82)。因此，耳念珠菌在欧洲诊所出现两年多后，比利时微生物学家的认识仍然不足。我们的数据证实常用识别方法的误识别率很高。可能有必要在欧洲医院开展提高认识的计划。
Candida auris is a difficult-to-identify, emerging yeast and a cause of sustained nosocomial outbreaks. Presently, not much data exist on laboratory preparedness in Europe. To assess the ability of laboratories in Belgium and Luxembourg to detect this species, a blinded C. auris strain was included in the regular proficiency testing rounds organized by the Belgian public health institute, Sciensano. Laboratories were asked to identify and report the isolate as they would in routine clinical practice, as if grown from a blood culture. Of 142 respondents, 82 (57.7%) obtained a correct identification of C. auris. Of 142 respondents, 27 (19.0%) identified the strain as Candida haemulonii. The remaining labs that did not obtain a correct identification (33/142, 23.2%), reported other yeast species (4/33) or failed to obtain a species identification (29/33). To assess awareness about the infection-control implications of the identification, participants were requested to indicate whether referral of this isolate to a reference laboratory was desirable in a clinical context. Over one-third of all respondents (54/142, 38.0%) stated that they would not send the isolate to a reference laboratory, neither for epidemiological reasons nor for identification confirmation or antifungal susceptibility testing. This comprised 41.5% of the laboratories that submitted an identification of C. auris (34/82). Awareness among Belgian microbiologists, therefore, remains inadequate more than two years after C. auris' emergence in European clinics. Our data confirm high rates of misidentifications with commonly used identification methods. Programs for raising awareness in European hospitals may be warranted.