Pan-Echinocandin-Resistant Candida glabrata Bloodstream Infection Complicating COVID-19: A Fatal Case Report.
Pan-Echinocandin-Resistant Candida glabrata Bloodstream Infection Complicating COVID-19: A Fatal Case Report.
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DOI：
10.3390/jof6030163
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发表时间：
2020-09-06
期刊：
影响因子：
--
通讯作者：
Fantoni M
中科院分区：
文献类型：
--
作者：
Posteraro B;Torelli R;Vella A;Leone PM;De Angelis G;De Carolis E;Ventura G;Sanguinetti M;Fantoni M
细菌或真菌合并感染可能是 COVID-19 的常见并发症，但 COVID-19 患者中念珠菌属的合并感染仍然很少见。我们报告了一名被诊断患有 COVID-19 的复杂 2 型糖尿病患者的 53 天临床病程，该患者最初由于耐甲氧西林金黄色葡萄球菌而出现血流感染，其次是由于多重耐药革兰氏阴性菌，最后是由于可能致命的光滑念珠菌。卡泊芬净治疗 13 天后，从患者体内分离出的光滑念珠菌出现了与 FKS 相关的全棘白菌素耐药性，这使得情况更加恶化。该患者在有望接受潜在有效的抗真菌治疗前不久死于感染性休克。该病例强调了早期诊断和监测抗菌药物耐药性合并感染的重要性，以减少其对 COVID-19 患者的不利结果。
Coinfections with bacteria or fungi may be a frequent complication of COVID-19, but coinfections with Candida species in COVID-19 patients remain rare. We report the 53-day clinical course of a complicated type-2 diabetes patient diagnosed with COVID-19, who developed bloodstream infections initially due to methicillin-resistant Staphylococcus aureus, secondly due to multidrug-resistant Gram-negative bacteria, and lastly due to a possibly fatal Candida glabrata. The development of FKS-associated pan-echinocandin resistance in the C. glabrata isolated from the patient after 13 days of caspofungin treatment aggravated the situation. The patient died of septic shock shortly before the prospect of receiving potentially effective antifungal therapy. This case emphasizes the importance of early diagnosis and monitoring for antimicrobial drug-resistant coinfections to reduce their unfavorable outcomes in COVID-19 patients.
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