Epidemiology and risk factors of candidemia due to Candida parapsilosis in an intensive care unit.
Epidemiology and risk factors of candidemia due to Candida parapsilosis in an intensive care unit.
复制标题
重症监护病房近平滑念珠菌引起念珠菌血症的流行病学及危险因素
DOI：
10.1590/s1678-9946202163020
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发表时间：
2021
影响因子：
1.9
通讯作者：
Hu K
中科院分区：
文献类型：
--
作者：
Zuo XS;Liu Y;Hu K
摘要分析了念珠菌血症的临床特点及危险因素。近平滑（n=104）在一家三级医院的重症监护室超过6年。这是一项于2013年1月至2019年3月进行的念珠菌血症单中心回顾性研究。分析267例念珠菌血症患者的流行病学特征、临床特征、侵入性操作、实验室检查和转归，以确定念珠菌血症的危险因素。近平滑63例C.白色念珠菌204例，非白色念珠菌204例。白色念珠菌（NCAC）104例，其中白色念珠菌104例，白色念珠菌104例。近平滑型100例，非C. 46例为白色念珠菌（C.albicans）。tropicalis，C. glabrata、C. guilliermondii、5例C. krusei和4例C. lusitaniae），表明C.近平滑是从念珠菌血症病例中分离出的主要念珠菌。二项多因素Logistic回归分析显示，APACHE II评分、中心静脉置管、广谱抗生素使用与C.近平滑念珠菌血症的OR值分别为1.159、3.913和2.217。结果表明，C.近平滑是ICU患者NCAC念珠菌血症的主要致病菌。APACHE Ⅱ评分、中心静脉置管、使用广谱抗生素是发生C.近平滑念珠菌血症，这可能提供的数据，以支持早期引入抗真菌治疗。
ABSTRACT We analyzed the clinical features and risk factors of candidemia due to C. parapsilosis (n=104) in the intensive care unit of a tertiary hospital over six years. This was a monocentric, retrospective study of candidemia, conducted from January 2013 to March 2019. Epidemiological characteristics, clinical features, invasive procedures, laboratory data and outcomes of 267 patients with candidemia were analyzed to determine risk factors of candidemia due to C. parapsilosis. Sixty-three cases of C. albicans and 204 cases of non-C. albicans Candida (NCAC) species were included, the latter was composed of 104 cases of C. parapsilosis and 100 cases of non-C. albicans species (46 cases of C. tropicalis, 22 cases of C. glabrata, 23 cases of C. guilliermondii, 5 cases of C. krusei and 4 cases of C. lusitaniae), suggesting that C. parapsilosis was the predominant Candida species isolated from cases of candidemia. A binary multivariate logistic regression analysis showed that APACHE II scores, central venous catheterization and the use of broad-spectrum antibiotics were closely related to C. parapsilosis candidemia, with OR values of 1.159, 3.913 and 2.217, respectively. In conclusion, we found that C. parapsilosis was the main pathogen among the NCAC candidemia in the ICU patients. APACHE II scores, central venous catheterization and the use of broad-spectrum antibiotics were independent risk factors for the occurrence of C. parapsilosis candidemia, which may provide data to support the early introduction of anti-fungal therapy.