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首页> 外文期刊>Journal of Clinical Microbiology >Epidemiology, Risk Factors, and Prognosis of Candida parapsilosis Bloodstream Infections: Case-Control Population-Based Surveillance Study of Patients in Barcelona, Spain, from 2002 to 2003
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Epidemiology, Risk Factors, and Prognosis of Candida parapsilosis Bloodstream Infections: Case-Control Population-Based Surveillance Study of Patients in Barcelona, Spain, from 2002 to 2003

机译：副念珠菌血流感染的流行病学，危险因素和预后：2002年至2003年在西班牙巴塞罗那进行的基于病例对照人群的患者监测研究

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Candida parapsilosis has emerged as an important yeast species causing fungemia. We describe the incidence and epidemiology of C. parapsilosis fungemia. Data from active population-based surveillance in Barcelona, Spain, from January 2002 to December 2003 were analyzed. We focused on 78 episodes of C. parapsilosis fungemia, and we compared them with 175 Candida albicans controls. C. parapsilosis accounted for 23% of all fungemias. The annual incidences were 1 episode per 105 patients, 1.2 episodes per 104 discharges, and 1.7 episodes per 105 patient days. All isolates but one (99%) were fluconazole susceptible. Seventy-two isolates (92%) were inpatient candidemias. Forty-two episodes (51%) were considered catheter-related fungemia, 35 (45%) were considered primary fungemia, and 3 (4%) were considered secondary fungemia. Risk factors for candidemia were vascular catheterization (97%), prior antibiotic therapy (91%), parenteral nutrition (54%), prior surgery (46%), prior immunosuppressive therapy (38%), malignancy (27%), prior antifungal infection (26%), transplant recipient (16%), neutropenia (12%), and prior colonization (11%). Multivariate analysis of the differential characteristics showed that the factors that independently predicted the presence of C. parapsilosis fungemia were neonate patients (odds ratio [OR], 7.5; 95% confidence interval [CI], 2.1 to 26.8; P = 0.002), transplant recipients (OR, 9.2; 95% CI, 1.9 to 43.3; P = 0.005), patients with a history of prior antifungal therapy (OR, 5.4; 95% CI, 1.8 to 15.9; P = 0.002), and patients who received parenteral nutrition (OR, 2.2; 95% CI, 1.09 to 4.6; P = 0.028). The overall mortality rate was lower than that associated with C. albicans candidemia (23% versus 43%; P < 0.01). In summary, C. parapsilosis was responsible for 23% of all candidemias and was more frequent in neonates, in transplant recipients, and in patients who received parenteral nutrition or previous antifungal therapy, mainly fluconazole. The mortality rate was lower than that associated with C. albicans fungemia.
机译：副寄生念珠菌已成为引起真菌病的重要酵母菌种。我们描述了 C的发病率和流行病学。副滑落性真菌病。分析了2002年1月至2003年12月在西班牙巴塞罗那进行的基于人群的主动监视数据。我们重点研究了78集 C。寄生性真菌病，我们将它们与175个白色念珠菌对照进行了比较。 C。寄生虫病占所有真菌病的23％。年发病率为每10 5 患者1次发作，每10 4 出院1.2次发作，每10 5 患者日1.7次发作。除一个分离株（99％）外，所有分离株均对氟康唑敏感。住院的念珠菌病有72株（占92％）。四十二例（51％）被认为是导管相关性真菌病，三十五例（45％）被认为是原发性真菌病，三例（4％）被认为是继发性真菌病。念珠菌血症的危险因素是血管导管插入术（97％），先前的抗生素治疗（91％），肠胃外营养（54％），先前的手术（46％），先前的免疫抑制治疗（38％），恶性（27％），先前的抗真菌药感染（26％），移植受者（16％），中性粒细胞减少症（12％）和先前定植（11％）。差异特征的多变量分析表明，独立预测 C的因素。新生儿肺炎旁真菌性感染（几率[OR]为7.5; 95％置信区间[CI]为2.1至26.8; P = 0.002），接受移植的患者（OR为9.2; 95） ％CI，1.9至43.3; P = 0.005），曾有抗真菌治疗史的患者（OR，5.4; 95％CI，1.8至15.9; P = 0.002 ）以及接受肠胃外营养的患者（OR为2.2; 95％CI为1.09至4.6; P = 0.028）。总死亡率低于与 C有关的死亡率。白色念珠菌念珠菌血症（23％比43％; P <0.01）。总之， C。寄生虫病占所有念珠菌病的23％，在新生儿，移植受者以及接受肠胃外营养或以前接受过抗真菌治疗（主要是氟康唑）的患者中更为常见。死亡率低于与 C有关的死亡率。白色念珠菌真菌病。

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