Rare opportunistic (non-Candida, non-Cryptococcus) yeast bloodstream infections in patients with cancer.
Rare opportunistic (non-Candida, non-Cryptococcus) yeast bloodstream infections in patients with cancer.
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DOI：
10.1016/j.jinf.2011.11.002
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发表时间：
2012-01
影响因子：
28.2
通讯作者：
Kontoyiannis, Dimitrios P.
中科院分区：
文献类型：
--
作者：
Chitasombat, Maria N.;Kofteridis, Diamantis P.;Jiang, Ying;Tarrand, Jeffrey;Lewis, Russell E.;Kontoyiannis, Dimitrios P.
罕见的机会性（非念珠菌、非隐球菌）酵母血流感染 (ROYBSI) 很少见，即使在癌症患者中也是如此。我们回顾性回顾了 1998 年至 2010 年在我们癌症中心发生的所有 ROYBSI 事件。在 2984 份念珠菌和非念珠菌酵母菌血培养呈阳性的样本中，94 份（3.1%）为非念珠菌酵母菌阳性，代表 41 个 ROYBSI（发病率，2.1 例/100,000 患者日）。 21 名 (51%) 患者出现导管相关性真菌血症。 20 名 (49%) 患者出现了突破性 ROYBSI。酵母菌种类分布为：21 名患者（51%）为红酵母，8 名患者（20%）为毛孢菌，8 名患者（20%）为酿酒酵母，2 名患者（5%）为地霉，异常毕赤酵母和糠秕马拉色菌各 1 名。所有测试的丝孢菌属、地霉属和毕赤酵母属菌株均对唑类敏感，而红酵母属菌株大多对唑类具有抗性。我们注意到除酿酒酵母之外的所有菌株均对棘白菌素不敏感（最低抑菌浓度≥2 mg/L）。大多数分离株 (28/33 [85%]) 对两性霉素 B 敏感。ROYBSI 诊断后 30 天时所有患者的死亡率为 34%。多变量生存分析显示，酿酒酵母感染（风险比，3.7）、地霉感染（风险比，111.3）或播散性感染（风险比，33.4）的患者死亡风险增加，而拔除导管的患者风险降低（风险比，0.1）。 ROYBSI 在癌症患者中并不常见，导管是其常见来源。一半的 ROYBSI 发生为突破性感染，体外对棘白菌素和唑类药物的物种特异性耐药性很常见。传播性感染导致高死亡率。
Rare opportunistic (non-Candida, non-Cryptococcus) yeast bloodstream infections (ROYBSIs) are rare, even in cancer patients. We retrospectively reviewed all episodes of ROYBSIs occurring from 1998 to 2010 in our cancer center. Of 2984 blood cultures positive for Candida and non-Candida yeasts, 94 (3.1%) were positive for non-Candida yeasts, representing 41 ROYBSIs (incidence, 2.1 cases/100,000 patient-days). Catheter-associated fungemia occurred in 21 (51%) patients. Breakthrough ROYBSIs occurred in 20 (49%) patients. The yeast species distribution was Rhodotorula in 21 (51%) patients, Trichosporon in 8 (20%) patients, Saccharomyces cerevisiae in 8 (20%) patients, Geotrichum in 2 (5%) patients, Pichia anomala, and Malassezia furfur in 1 patient each. All tested Trichosporon, Geotrichum, and Pichia isolates were azole-susceptible, whereas the Rhodotorula isolates were mostly azole-resistant. We noted echinocandin nonsusceptibility (minimal inhibitory concentration ≥ 2 mg/L) in all but the S. cerevisiae isolates. Most of the isolates (28/33 [85%]) were susceptible to amphotericin B. The mortality rate in all patients at 30 days after ROYBSIs diagnosis was 34%. Multivariate survival analysis revealed increased risk of death in patients with S. cerevisiae infections (hazard ratio, 3.7), Geotrichum infections (hazard ratio, 111.3), or disseminated infections (hazard ratio, 33.4) and reduced risk in patients who had catheter removal (hazard ratio, 0.1). ROYBSIs are uncommon in patients with cancer, and catheters are common sources of them. Half of the ROYBSIs occurred as breakthrough infections, and in vitro species-specific resistance to echinocandins and azoles was common. Disseminated infections resulted in the high mortality rate.
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影响因子：
--
作者：
Kontoyiannis, DP;Torres, HA;Raad, II
通讯作者：
Raad, II
DOI：
10.1016/0732-8893(92)90118-d
发表时间：
1992-03-01
影响因子：
2.9
作者：
BRYCE, EA;ROBERTS, FJ;COLDMAN, AJ
通讯作者：
COLDMAN, AJ
影响因子：
11.8
作者：
DUTHIE, R;DENNING, DW
通讯作者：
DENNING, DW
影响因子：
14.2
作者：
Lionakis, MS;Bodey, GP;Kontoyiannis, DP
通讯作者：
Kontoyiannis, DP
影响因子：
7.5
作者：
Bayramoglu, G.;Sonmez, M.;Aydin, F.
通讯作者：
Aydin, F.