Candida colonisation as a source for candidaemia
Candida colonisation as a source for candidaemia
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DOI：
10.1016/j.jhin.2009.02.009
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发表时间：
2009-05-01
影响因子：
6.9
通讯作者：
Levin, A. S.
中科院分区：
文献类型：
--
作者：
Miranda, L. N.;van der Heijden, I. M.;Levin, A. S.
念珠菌是重要的保健相关病原体。确定感染源对于预防和控制战略非常重要。本研究的目的是评估念珠菌定植位点作为念珠菌血症的潜在来源。纳入63例连续血培养念珠菌阳性的患者。收集尿液、直肠、口咽部、皮肤、导管导管尖端和导管周围皮肤的监测培养物。当从患者的血液和监测点分离到相同种类的念珠菌时，进行分子分型。白色念珠菌占念珠菌总数的42%，副枯枝念珠菌占33%，热带念珠菌占16%，吉列蒙地念珠菌、克氏念珠菌、光秃念珠菌、荷尔米念珠菌和枯枝念珠菌各占2%。10个C. parapsilosis导管尖端分离株中有6个与相应的血液分离株（均为新生儿）难以区分。26例患者中有13例从血液中分离出白色念珠菌，2例从导管尖端分离出白色念珠菌。总之，结果表明胃肠道定植可能是白色念珠菌血症的来源，而假丝酵母菌是外源性的。(C) 2009年医院，感染学会。Elsevier Ltd.出版。版权所有。
Candida spp. are important healthcare-associated pathogens. Identifying the source of infection is important for prevention and control strategies. The objective of this study was to evaluate candida colonisation sites as potential sources for candidaemia. Sixty-three consecutive patients with a positive blood culture for candida were included. Surveillance cultures were collected from urine, rectum, oropharynx, skin, intravascular catheter tip and skin around catheter. Molecular typing was performed when the same species of candida was isolated from blood and surveillance sites of a patient. C. albicans was associated with 42% of candidaemias, C. parapsilosis 33%, C. tropicalis 16% and C. guilliermondii, C. krusei, C. glabrata, C. holmii and C. metapsilosis were all 2% each. Six of 10 C. parapsilosis catheter tip isolates were indistinguishable from corresponding blood isolates (all in neonates). C. albicans isolates from blood were indistinguishable from corresponding gastrointestinal, tract isolates in 13 of 26 patients and from catheter tip isolates in two patients. In conclusion, the results suggest that gastrointestinal colonisation is the probable source of C. albicans candidaemia and C. parapsilosis is exogenous. (C) 2009 The Hospital, Infection Society. Published by Elsevier Ltd. All rights reserved.