Factors associated with the development of ocular candidiasis and ocular prognosis with echinocandin therapy for candidemia.
Factors associated with the development of ocular candidiasis and ocular prognosis with echinocandin therapy for candidemia.
复制标题
与眼部念珠菌病发生相关的因素以及棘白菌素治疗念珠菌血症的眼部预后。
DOI：
10.1186/s12348-021-00248-0
复制
发表时间：
2021-06-14
影响因子：
2.9
通讯作者：
Nakamura M
中科院分区：
文献类型：
--
作者：
Sakai D;Matsumiya W;Kusuhara S;Nakamura M
评估与眼部念珠菌病（OC）发生相关的因素以及棘白菌素治疗念珠菌血症的眼部预后。回顾性审查了 2016 年 11 月至 2019 年 10 月期间连续 56 名念珠菌血培养呈阳性患者的病历。提取有关患者特征、分离的念珠菌种类、念珠菌血症治疗细节和眼部检查结果的信息，以确定与 OC 发展相关的因素。念珠菌血症的主要病原体是白色念珠菌（C.albicans）（41.1%）。在 56 名患者中，18 名 (32.1%) 被诊断患有脉络膜视网膜炎，分为可能 (8 名患者) 或可能 OC (10 名患者)。无眼内炎合并玻璃体炎病例。使用棘白菌素和其他抗真菌药物治疗的组之间，可能的 OC 发生率没有显着差异（15.2% vs. 11.1%，p = 1.00）。在所有可能的 OC 病例中，全身抗真菌治疗从棘白菌素类药物改为唑类药物，没有病例进展为眼内炎。多变量逻辑分析显示，女性（调整后优势比 [aOR]，8.93；95% 置信区间 [CI]，1.09–72.9）和白色念珠菌（aOR，23.6；95% CI，1.8–281）是与可能的 OC 发生相关的独立因素。七分之一的念珠菌血症患者可能发展为 OC。鉴于女性和白色念珠菌是与 OC 发展相关的因素，因此需要对这些因素进行仔细的眼科管理，特别是在念珠菌血症中。虽然棘白菌素与 OC 的发展没有相关性，也不会导致眼部预后恶化，但仍需要进一步研究。在线版本包含可在 10.1186/s12348-021-00248-0 获取的补充材料。
To evaluate the factors associated with the development of ocular candidiasis (OC) and ocular prognosis with echinocandin therapy for candidemia. The medical records of 56 consecutive patients with a positive blood culture for Candida species between November 2016 and October 2019 were retrospectively reviewed. Information on patient characteristics, isolated Candida species, treatment details for candidemia, and ocular findings were extracted to identify factors associated with OC development. The leading pathogen of candidemia was Candida albicans (C.albicans) (41.1%). Of 56 patients, 18 (32.1%) were diagnosed with chorioretinitis, categorized as either probable (8 patients) or possible OC (10 patients). There was no case of endophthalmitis with vitritis. The incidence of probable OC was not significantly different between the groups treated with echinocandins and other antifungal drugs (15.2% vs. 11.1%, p = 1.00). In all probable OC cases, systemic antifungal therapy was switched from echinocandins to azoles, and no case progressed to endophthalmitis. A multivariate logistic analysis revealed that female sex (adjusted odds ratio [aOR], 8.93; 95% confidence interval [CI], 1.09–72.9) and C. albicans (aOR, 23.6; 95% CI, 1.8–281) were independent factors associated with the development of probable OC. One-seventh of patients with candidemia developed probable OC. Given the evidence of female and C. albicans as the factors associated with OC development, careful ophthalmologic management is required with these factors, especially in candidemia. Although echinocandins had no correlation with OC development and did not lead to the deterioration of ocular prognosis, further investigation is required. The online version contains supplementary material available at 10.1186/s12348-021-00248-0.
登录
查看更多内容
影响因子：
5.2
作者：
Abe M;Kinjo Y;Ueno K;Takatsuka S;Nakamura S;Ogura S;Kimura M;Araoka H;Sadamoto S;Shinozaki M;Shibuya K;Yoneyama A;Kaku M;Miyazaki Y
通讯作者：
Miyazaki Y
影响因子：
6.4
作者：
HENDERSON, DK;EDWARDS, JE;MONTGOMERIE, JZ
通讯作者：
MONTGOMERIE, JZ
影响因子：
13.7
作者：
PARKE, DW;JONES, DB;GENTRY, LO
通讯作者：
GENTRY, LO
影响因子：
158.5
作者：
Mora-Duarte, J;Betts, R;Perfect, J
通讯作者：
Perfect, J
影响因子：
13.7
作者：
DONAHUE, SP;GREVEN, CM;LU, VL
通讯作者：
LU, VL