Clinical Outcomes of Patients Treated for Candida auris Infections in a Multisite Health System, Illinois, USA
Clinical Outcomes of Patients Treated for Candida auris Infections in a Multisite Health System, Illinois, USA
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DOI：
10.3201/eid2605.191588
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发表时间：
2020-05-01
影响因子：
11.8
通讯作者：
Dela Pena, Jennifer
中科院分区：
文献类型：
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作者：
Arensman, Kellie;Miller, Jessica L.;Dela Pena, Jennifer
耳念珠菌是一种新兴的真菌病原体，通常对氟康唑具有耐药性，并且已知会导致医疗保健相关的疫情爆发。我们回顾性审查了 2018 年 5 月至 2019 年 4 月期间，美国伊利诺伊州多地点卫生系统内 28 名耳念珠菌培养结果呈 >1 阳性的患者。其中 12 名患者因耳念珠菌感染而住院治疗； 10 例 (83%) 符合临床成功标准，定义为自第一次培养阳性起 30 天后不存在全因死亡、耳念珠菌复发和感染相关的再入院。另外2名患者（17%）在30天内死亡。大多数患者（92%）接受了米卡芬净的经验治疗。 28 株分离株中，4 株（14%）对氟康唑耐药，1 株（3.6%）对两性霉素 B 耐药，1 株（3.6%）对棘白菌素耐药。我们的研究结果表明，大多数耳念珠菌患者的抗真菌耐药率较低，临床结果良好。
Candida auris is an emerging fungal pathogen that is typically resistant to fluconazole and is known to cause healthcare-associated outbreaks. We retrospectively reviewed 28 patients who had >1 positive culture for C. auris within a multisite health system in Illinois, USA, during May 2018-April 2019. Twelve of these patients were treated as inpatients for C. auris infections; 10 (83%) met criteria for clinical success, defined as absence of all-cause mortality, C. auris recurrence, and infection-related readmission at 30 days from the first positive culture. The other 2 patients (17%) died within 30 days. Most patients (92%) were empirically treated with micafungin. Four (14%) of 28 total isolates were resistant to fluconazole, 1 (3.6%) was resistant to amphotericin B, and 1 (3.6%) was resistant to echinocandins. Our findings describe low rates of antifungal resistance and favorable clinical outcomes for most C. auris patients.