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首页> 外文期刊>Journal of Clinical Microbiology >Species Identification and Antifungal Susceptibility Testing of Candida Bloodstream Isolates from Population-Based Surveillance Studies in Two U.S. Cities from 2008 to 2011
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Species Identification and Antifungal Susceptibility Testing of Candida Bloodstream Isolates from Population-Based Surveillance Studies in Two U.S. Cities from 2008 to 2011

机译：2008年至2011年美国两个城市基于人群的监测研究中念珠菌血流分离物的种类鉴定和抗真菌药敏性测试

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Between 2008 and 2011, population-based candidemia surveillance was conducted in Atlanta, GA, and Baltimore, MD. Surveillance had been previously performed in Atlanta in 1992 to 1993 and in Baltimore in 1998 to 2000, making this the first population-based candidemia surveillance conducted over multiple time points in the United States. From 2,675 identified cases of candidemia in the current surveillance, 2,329 Candida isolates were collected. Candida albicans no longer comprised the majority of isolates but remained the most frequently isolated species (38%), followed by Candida glabrata (29%), Candida parapsilosis (17%), and Candida tropicalis (10%). The species distribution has changed over time; in both Atlanta and Baltimore the proportion of C. albicans isolates decreased, and the proportion of C. glabrata isolates increased, while the proportion of C. parapsilosis isolates increased in Baltimore only. There were 98 multispecies episodes, with C. albicans and C. glabrata the most frequently encountered combination. The new species-specific CLSI Candida MIC breakpoints were applied to these data. With the exception of C. glabrata (11.9% resistant), resistance to fluconazole was very low (2.3% of isolates for C. albicans, 6.2% for C. tropicalis, and 4.1% for C. parapsilosis). There was no change in the proportion of fluconazole resistance between surveillance periods. Overall echinocandin resistance was low (1% of isolates) but was higher for C. glabrata isolates, ranging from 2.1% isolates resistant to caspofungin in Baltimore to 3.1% isolates resistant to anidulafungin in Atlanta. Given the increase at both sites and the higher echinocandin resistance, C. glabrata should be closely monitored in future surveillance.
机译：在2008年至2011年之间，在乔治亚州亚特兰大和马里兰州巴尔的摩进行了基于人群的念珠菌病监测。此前曾于1992年至1993年在亚特兰大进行监视，并于1998年至2000年在巴尔的摩进行了监视，这使它成为在美国多个时间点进行的首次基于人群的念珠菌病监测。在目前的监测中，从2675例确诊的念珠菌病病例中，收集了2329株念珠菌分离株。白色念珠菌不再占大多数分离物，但仍是分离最频繁的物种（38％），其次是光滑念珠菌（29％），副念珠菌（17％）和热带念珠菌（10％）。物种分布随时间而变化;在亚特兰大和巴尔的摩，仅白色念珠菌分离物的比例下降，而光滑念珠菌分离物的比例增加，而副寄生念珠菌分离物的比例仅在巴尔的摩增加。有98种多物种发作，其中白色念珠菌和光滑念珠菌是最常遇到的组合。新的特定于物种的CLSI Candida MIC断点已应用于这些数据。除了光滑念珠菌（耐药性为11.9％）外，对氟康唑的耐药性非常低（白色念珠菌的分离株为2.3％，热带念珠菌的分离株为6.2％，副寄生念珠菌的分离率为4.1％）。监测期之间氟康唑耐药率的比例没有变化。整体棘皮菌素耐药性较低（占分离物的1％），但对光滑念珠菌分离物则较高，范围从巴尔的摩的2.1％菌株对卡泊芬净耐药，到亚特兰大的3.1％菌株对阿尼芬净耐药。鉴于这两个地点的增加和棘皮菌素的较高耐药性，应在未来的监测中密切监测光滑念珠菌。

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