FKS Mutant Candida glabrata: Risk Factors and Outcomes in Patients With Candidemia
FKS Mutant Candida glabrata: Risk Factors and Outcomes in Patients With Candidemia
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DOI：
10.1093/cid/ciu407
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发表时间：
2014-09-15
影响因子：
11.8
通讯作者：
Garey, Kevin W.
中科院分区：
文献类型：
--
作者：
Beyda, Nicholas D.;John, Julie;Garey, Kevin W.
背景建议使用棘白菌素治疗光滑念珠菌性念珠菌血症。FKS 1和FKS 2基因的突变与棘白菌素抗性相关。很少有研究评估了接受米卡芬净治疗的患者中FKS突变分离株和结局的风险因素。C.本研究纳入了2009年至2012年期间在一家大型三级护理医院住院的glabrata血流感染患者。对于每种分离株，对FKS 1和FKS 2基因进行测序以鉴定突变。采用多变量logistic回归分析对接受棘白菌素治疗的患者的FKS突变和治疗结果的危险因素进行评估。72例患者纳入研究，其中13例（18%）具有FKS突变分离株。FKS突变的唯一显著预测因素是既往棘白菌素暴露（比值比[OR]，19.9; 95%置信区间[CI]，4.7-84.7; P
Background. Echinocandins are recommended for Candia glabrata candidemia. Mutations in the FKS1 and FKS2 genes are associated with echinocandin resistance. Few studies have assessed risk factors for FKS mutant isolates and outcomes in patients receiving micafungin treatment.Methods. Patients with C. glabrata bloodstream infection admitted to a large, tertiary care hospital between 2009 and 2012 were included in this study. For each isolate, FKS1 and FKS2 genes were sequenced to identify mutations. Risk factors for FKS mutations and treatment outcomes in patients receiving an echinocandin were assessed using multivariate logistic regression.Results. Seventy-two patients were included in the study of which 13 (18%) had an FKS mutant isolate. The only significant predictor for FKS mutations was prior echinocandin exposure (odds ratio [OR], 19.9; 95% confidence interval [CI], 4.7-84.7; P