持续性候群病的危险因素和预后影响:来自ECMM Candida III研究的结果
Sarah Sedik1, Matthias Egger1, Stella Wolfgruber1
1Division of Infectious Diseases, Translational Medical Mycology Research Unit, European Confederation of Medical Mycology Excellence Center for Medical Mycology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
The Journal of infection
|October 17, 2025
概括
持续的白血病,通常与缺乏遵守指导方针,如初始使用 echinocandin 相关,显著增加死亡风险. 早期的真菌清除对于在重症患者中获得更好的结果至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 菌类学 菌类学是指菌类学.
背景情况:
- кандидемия对重症患者和免疫受损的个体构成严重威胁,患病率和死亡率很高.
- 早期根除Candida血流感染可能会改善患者的治疗结果.
- 阳性随访血液培养 (FUBC) 结果对候选血症的临床意义尚未完全理解.
研究的目的:
- 为了确定持久性候选血病的预测因素.
- 评估FUBC阳性结果对临床结果的影响,包括死亡率.
- 分析遵守治疗指南和持续的候选血病之间的关联.
主要方法:
- 多中心ECMMCandida III研究的子分析,涉及258名成年患有培养证明的候选血病的患者.
- 使用二进制后勤回归的统计分析,以找到持久性候群病的预测因子.
- 考克斯的比例危险回归模型被用来评估死亡风险因素.
主要成果:
- 在20.2%的患者中,持续性候选血症发生,平均持续时间为6天.
- 较低的EQUAL Candida评分,表明对指导方针的坚持不佳 (尤其是缺乏初始的 echinocandin 使用),预测持续的候选血症.
- 持续5天以上的候选血症和重症监护室 (ICU) 的入院是死亡率的独立预测因素.
结论:
- 对治疗指导方针的不良遵守,反映在低EQUAL Candida评分,与持续的候选血症有关.
- 持续持续≥5天的候选血是死亡率的重要独立预测因子.
- 确保遵守指导方针,包括适当的初始抗真菌疗法,对于改善候选血症结果至关重要.
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