临床特征和临床结果在患有密码球菌病的患者从一个大型基于人口的队列
Adam G Stewart1,2,3, Kevin B Laupland4,5, Felicity Edwards4,5
1Transplant and Immunocompromised Host Infectious Diseases, Infectious Diseases Division, Massachusetts General Hospital, Boston, Massachusetts, USA.
Mycoses
|July 8, 2025
概括
菌血流感染 (BSI) 是致命的,特别是在非艾滋病毒患者. 越来越多的Cryptococcus neoformans复合体对可纳耐药性的增加是一个越来越令人担忧的问题,需要持续监测.
科学领域:
- 医学真菌学 医学真菌学
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 加密球菌血流感染 (BSI),或加密球菌病,是严重的机会性感染,死亡率高.
- 这些感染主要影响免疫功能低下的人或患有末期器官疾病的人.
- 关于感染趋势,宿主因素,地理变异,抗真菌耐药性和临床结果的基于人口的研究有限.
研究的目的:
- 在20年的时间内,检查趋势并确定与加密血病死亡率相关的风险因素.
- 研究宿主因素,地理位置和抗真菌耐药性对临床结果的影响.
- 为管理和预防加密球菌感染的策略提供信息.
主要方法:
- 从2000年1月1日到2019年12月31日,对血培养的回顾性分析对Cryptococcus物种呈阳性.
- 收集和分析临床,微生物学和结果数据.
- 生存分析以确定特征与死亡率之间的关联.
主要成果:
- 鉴定了118例加密球菌血症 (115名患者);Cryptococcus neoformans复合物导致98%的感染.
- 总体30天死亡率为34%,与非艾滋病毒相关病例 (41.7%) 相比,与艾滋病毒相关病例 (12.5%) 相比,非艾滋病毒相关病例显著增加.
- 在C. neoformans复合体中增加可纳最小抑制度 (MIC) 值与增加的死亡率相关; 46%的MIC ≥8 mg/L的隔离物是在最近的5年期间.
结论:
- 加密球菌BSI具有高度致命性,特别是在非艾滋病毒感染个体中.
- 血液培养物收集对于诊断密码球菌感染和指导治疗至关重要.
- 由于新出现的耐药性模式,对可纳敏感性的持续监测至关重要.
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