Abstract:Objective To investigate the current fungal blood stream infections and to provide reference for the prevention and treatment of fungemia.Methods Retrospective analysis was used to test the results of fungal blood stream infections in a military hospital between 2013 and 2018. The species, distribution and drug resistance were analyzed.Results 97 strains of fungal blood stream infections were isolated, mainly Candida albicans(30.93%), but the proportion decreased(from 41.76% in 2013 to 27.78% in 2018). Fungal blood stream infections occurred most often in departments of hematology(24.74%) and intensive care medicine (22.68%). The sensitivities to four antimicrobial agents were as follows: 5-fluorocytosine (97.80%), voriconazole (97.80%), fluconazole (93.30%), and itraconazole (71.10%).Conclusions Candida albicans is the main fungus associated with blood stream infections, but infections with non-Candida albicans are on the rise. Improving immunity and reducing invasive examination and treatment are important to reduce fungal blood flow in fection.Triazoles are still the mainstream antifungal drugs, and resistance needs to be tested in the course of treatment.
李继霞, 薛炼, 武静, 崔海荣, 闵彦, 孙晓. 某部队医院2013-2018年真菌血流感染菌种分布和耐药性分析[J]. 武警医学, 2019, 30(9): 772-775.
LI Jixia, XUE Lian, WU Jing, CUI Hairong, MIN Yan, SUN Xiao. Distribution and drug resistance of fungal blood stream infections in a military hospital from 2013 to 2018. Med. J. Chin. Peop. Armed Poli. Forc., 2019, 30(9): 772-775.
Cornely O A, Gachot B, Akan H, et al. Epidemiology and outcome of fungemia in a cancer cohort of the Infectious Diseases Group (IDG) of the European Organization for Research and Treatment of Cancer (EORTC 65031) [J].Clin Infect Dis,2015,61(3):324-331.
[7]
Peron I H,Reichert L F,Busso L A F,et al.Resistance surveillance in Candida albicans:a five-year antifungal susceptibility evaluation in a Bbrazilian University Hospital[J]. PLoS One,2016,11(7):e0158126.
[8]
Eliakim R N,Babaoff R,Yahav D,et al.Epidemiology,microbiology,clinical characteristics,and outcomes of candidemia in internal medicine wards-a retrospective study[J].Int J Infect Dis,2016,52:49-54.
[9]
Montagna M T,Caggiano G,Lovero G,et al.Epidemiology of invasive fungal infections in the intensive care unit:results of a multicenter Italian survey(AURORA Project)[J].Infection,2013,41(3):645-653.
[10]
Guimaraes T,Nucci M, Mendonca J S,et al.Epidemiology and predictors of a poor outcome in elderly patients with candidemia[J].Int J Infect Dis,2012,16(6):e442-e447.
Calandra T,Roberts J A,Antonelli M,et al.Diagnosis and management of invasive candidiasis in the ICU: an updated approach to an old enemy[J].Crit Care,2016,20(1):125.