No evidence of increased ocular involvement in candidemic patients initially treated with echinocandins
No evidence of increased ocular involvement in candidemic patients initially treated with echinocandins
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DOI：
10.1016/j.diagmicrobio.2017.02.014
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发表时间：
2017-06-01
影响因子：
2.9
通讯作者：
Bouza, E.
中科院分区：
文献类型：
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作者：
Munoz, P.;Vena, A.;Bouza, E.
念珠菌素通常用作念珠菌血症患者的初始治疗，并且已知其难以扩散到眼组织中。我们的多中心研究的目的是评估最初用棘白菌素治疗的患者中眼睛受累是否更常见。我们对2010-2011年在西班牙实施的一项前瞻性、多中心、基于人群的念珠菌病监测项目（CANDIPOP项目）进行了事后分析，在168例接受眼底镜检查的念珠菌血症患者中，有13例（7.7%）检测到眼部受累。两名患者有眼内炎，而其余患者有脉络膜视网膜炎。在接受candins（3/56; 5.4%）或其他方案（10/112; 8.9%）初始治疗的患者中，眼部念珠菌病的发生率相似。在多变量分析中，眼部受累的风险条件为念珠菌血症后透析（OR，19.4; 95%CI，1.7-218.4）和眼部以外器官受累（OR，5.4; 95%CI，1.1-25.7）。总之，在接受棘白菌素初始治疗的患者中，未发现眼部受累比接受其他药物治疗的患者更频繁。(C)2017爱思唯尔公司All rights reserved.
Candins are commonly used as initial therapy in patients with candidemia and are known to diffuse poorly into ocular tissue. The aim of our multicenter study was to assess whether eye involvement was more common in patients initially treated with echinocandins. We performed a post hoc analysis of a prospective, multicenter, population-based candidemic surveillance program implemented in Spain during 2010-2011 (CANDIPOP project).Eye involvement was detected in 13 of 168 patients with candidemia (7.7%) who underwent ophthalmoscopy. Two patients had endophthalmitis, while the remaining patients had chorioretinitis. The frequency of ocular candidiasis was similar in patients receiving initial therapy with candins (3/56; 5.4%) or with other regimens (10/112; 8.9%). At multivariate analysis, risk conditions for eye involvement were dialysis after candidemia (OR, 19.4; 95% CI, 1.7-218.4) and involvement of organs other than the eye (OR, 5.4; 95% CI, 1.1-25.7). In conclusion, eye involvement was not found to be more frequent in patients receiving initial therapy with echinocandins than in patients receiving other drugs. (C) 2017 Elsevier Inc. All rights reserved.