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对真菌病的快速鉴定小组的评估

Emily A Siegrist¹, Bryan P White¹, Denise Robison²

¹Department of Pharmacy, OU Health, 700 NE 13th Str., Oklahoma City, OK 73104, USA.

JAC-antimicrobial resistance

|June 27, 2025

概括

对于检测血液感染中的酵母菌的ePlex (BCID-FP) 面板的真实世界灵敏度为94%. 快速的结果很少引导抗真菌降级,影响了抗微生物药物管理.

科学领域:

临床微生物学临床微生物学
传染性疾病传染性疾病
抗微生物药物管理委员会

背景情况:

酵母菌引起的血液感染的死亡率很高.
关于快速酵母检测系统的现实性能及其对抗微生物药物管理的影响的数据有限.
准确及时识别真菌病原体对于有效治疗至关重要.

研究的目的:

评估ePlex血液培养识别真菌/肺炎球菌 (BCID-FP) 面板的现实世界灵敏度,以快速检测阳性血液培养中的酵母菌.
评估快速BCID-FP结果对抗真菌治疗升级或降级决策的影响.
分析在研究群体中引起真菌病的常见酵母病原体.

主要方法:

对63次真菌病发作的回顾性评估.
与标准方法相比,评估了ePlex BCID-FP面板的灵敏度.
分析了基于BCID-FP结果的抗真菌治疗中的变化.

主要成果:

在现实世界中,BCID-FP面板的灵敏度为94%,低于制造商声称的灵敏度 (99%-100%).
发现的最常见的酵母病原体是 *Candida glabrata* (36%), *Candida albicans* (24%), *Candida parapsilosis* (10%) 和 *Candida krusei* (10%).
仅有57.1%的BCID-FP结果促使抗真菌治疗发生变化,大多数变化涉及启动一个echinocandin;降级很少发生.

结论:

在血流感染中检测酵母菌的ePlex BCID-FP面板的现实世界灵敏度低于理想条件下报告的.
使用BCID-FP小组快速识别酵母对指导抗真菌降级的影响有限,这表明需要改进管理整合.
这些发现强调了了解临床实践中的设备性能及其对患者管理和抗菌药物管理的影响的重要性.

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