Healthcare-associated fungal outbreaks: New and uncommon species, New molecular tools for investigation and prevention.
Healthcare-associated fungal outbreaks: New and uncommon species, New molecular tools for investigation and prevention.
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DOI：
10.1186/s13756-018-0338-9
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发表时间：
2018
影响因子：
5.5
通讯作者：
Zahar JR
中科院分区：
文献类型：
--
作者：
Bougnoux ME;Brun S;Zahar JR
近年来，医疗保健相关真菌感染的爆发已被多次描述，通常由新的或不常见的物种引起。最近描述的一种多药耐药酵母菌，耳念珠菌无疑是最令人担忧的物种，在四大洲引起了几次严重的侵入性感染的医疗保健爆发。此外，由于不常见的真菌物种，如突脐菌rostratum和Sarocladium kiliense，都与医疗产品的污染，但另一个爆发的来源，由腐毛菌棒，仍然没有解决。此外，这些暴发确定了除了那些通常有侵袭性真菌感染风险的人群（如免疫抑制和重症监护病房患者）之外的新的受威胁人群。所有这些疫情都突出表明了高度认识、快速诊断方法和新的分子分型工具（如全基因组测序）、及时调查和积极干预（包括通知公共卫生机构）的有用性。本综述总结了过去6年中报告的大多数由罕见或新的真菌病原体引起的卫生保健相关疫情的流行病学和临床数据，以及WGS作为调查感染源和最常用控制措施的支持的贡献。
Outbreaks of healthcare-associated fungal infections have repeatedly been described over recent years, often caused by new or uncommon species. Candida auris, a recently described multidrug-resistant yeast species, is certainly the most worrisome species having caused several severe healthcare outbreaks of invasive infections, on four continents. Also, large nosocomial outbreaks due to uncommon fungal species such as Exserohilum rostratum and Sarocladium kiliense, were both linked to contamination of medical products, however the source of another outbreak, caused by Saprochaete clavata, remains unresolved. Furthermore, these outbreaks identified new populations under threat in addition to those commonly at risk for invasive fungal infections, such as immunosuppressed and intensive care unit patients. All of these outbreaks have highlighted the usefulness of a high level of awareness, rapid diagnostic methods, and new molecular typing tools such as Whole Genome Sequencing (WGS), prompt investigation and aggressive interventions, including notification of public health agencies. This review summarizes the epidemiological and clinical data of the majority of healthcare-associated outbreaks reported over the last 6 years caused by uncommon or new fungal pathogens, as well as the contribution of WGS as support to investigate the source of infection and the most frequent control measures used.
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