Epidemiology And Antifungal Susceptibility Patterns Of Invasive Fungal Infections From 2012 To 2014 In A Teaching Hospital In Central China
Epidemiology And Antifungal Susceptibility Patterns Of Invasive Fungal Infections From 2012 To 2014 In A Teaching Hospital In Central China
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华中地区某教学医院2012-2014年侵袭性真菌感染流行病学及药敏分析
DOI：
10.2147/idr.s227839
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发表时间：
2019-01-01
影响因子：
3.9
通讯作者：
Xu, Ying-Chun
中科院分区：
文献类型：
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作者：
Xu, Hui;Yu, Shu-Ying;Xu, Ying-Chun
作为中国医院侵袭性真菌监测网络项目的参与者，我们试图描述从中国郑州大学第一附属医院的侵袭性真菌感染患者中获得的酵母菌分离株的流行病学和抗真菌药敏模式。方法：采用基质辅助激光解吸电离飞行时间质谱法对从血液和其他无菌体液中分离的434株酵母菌进行鉴定，并辅以或不辅以DNA测序。采用Sensititre YeastOne (TM) YO10方法检测抗真菌药敏。结果：2012 - 2014年，白色念珠菌是最常见的病原菌（33.9%），但发生率由37.2%下降至27.7%。其次是热带镰刀菌（25.1%），其次是副镰刀菌复合体（17.3%）、光秃秃镰刀菌（9%）和pelicullosa(6.7%)，其他种类占8%。Caspofungin、micafungin和anidulafungin对大多数念珠菌分离株具有较强的体外活性。氮唑对白色念珠菌的体外敏感性为> 95%，对假丝酵母菌复合体的体外敏感性为> 95%。对氟康唑和伏立康唑的耐药率分别为11.9%、9.1%和7.7%、28.2%。值得注意的是，包膜衣原体在新生儿中发病率较高，对氟康唑和伏立康唑的耐药率较高，分别为55.2%和41.4%。结论：本研究为侵染性酵母菌的流行病学和抗真菌敏感性监测提供了有价值的资料，对指导抗真菌治疗方案的制定具有重要意义。
Introduction: As participants of the national China Hospital Invasive Fungal Surveillance Net program, we sought to describe the epidemiology and antifungal susceptibility patterns of yeast isolates obtained from patients with invasive fungal infection at the First Affiliated Hospital of Zhengzhou University, China.Methods: A total of 434 yeast isolates recovered from blood and other sterile body fluids were identified to species by matrix-assisted laser desorption ionization -time of flight mass spectrometry with or without supplementation by DNA sequencing. Antifungal susceptibilities were determined by Sensititre YeastOne (TM) YO10 methodology.Results: Candida albicans was the most common causative species (33.9% of isolates) but significantly decreased in frequency from 37.2% to 27.7% from 2012 to 2014. C. tropicalis was the next most common pathogen (25.1%), followed by C. parapsilosis complex (17.3%), C. glabrata (9%), and C. pelliculosa (6.7%), with other species comprising 8% of isolates. Caspofungin, micafungin, and anidulafungin exhibited potent in vitro activities against the majority of Candida isolates. Azoles demonstrated in vitro activities against C. albicans with a susceptibility rate of > 95% and against C. parapsilosis complex, > 95% isolates were susceptible. Among C. tropicalis and C. glabrata isolates, resistance rates to fluconazole and voriconazole were 11.9%, 9.1% and 7.7%, 28.2%, respectively. Of note, C. pelliculosa had a high incidence rate in newborns and high rates of resistance to fluconazole and voriconazole of 55.2% and 41.4%, respectively.Conclusion: The present study provided valuable local surveillance data on the epidemiology and antifungal susceptibilities of invasive yeast species, which is essential for guiding antifungal treatment protocol development.