从ICU隔离的Candida物种 血流感染:分子流行病学,抗真菌耐药性和病毒性分析
Raunak Bir1, Kuhu Chatterjee2, Ankita Rai1
1Department of Microbiology, Employees' State Insurance Corporation (ESIC) Medical College and Hospital, Faridabad, IND.
Cureus
|November 20, 2025
概括
印度ICU中普遍存在Candida物种,特别是Candida tropicalis和Candida auris,它们表现出高可纳耐药性. 快速识别和抗真菌敏感性测试对于血液感染的有效治疗和监测至关重要.
科学领域:
- 医学真菌学 医学真菌学
- 传染性疾病 传染性疾病
- 密集护理医学 密集护理医学
背景情况:
- 由*Candida*物种引起的血流感染 (BSI) 在重症监护室 (ICU) 面临重大挑战.
- 了解印度ICU中*Candida*的流行病学和耐药性模式对于患者管理至关重要.
研究的目的:
- 为了确定印度ICU患者*Candida*分离物的物种分布.
- 分析这些分离物的毒性因子和抗真菌耐药性概况.
- 为了研究 *Candida* 菌株的遗传多样性和相关性.
主要方法:
- 使用微生物学和分子技术从血液样本中鉴定出100种*Candida*分离物.
- 根据临床和实验室标准研究所 (CLSI) 的指导方针进行的抗真菌敏感性测试.
- 病毒性概况包括血液溶解活性,酶生产和生物膜形成的评估.
- 多位元序列类型 (MLST) 和用于遗传多样性分析的测序.
主要成果:
- 非白 *Candida* (NAC) 种类占隔离物的82%,其中 *Candida tropicalis* (39%) 和 *Candida auris* (17%) 是最常见的.
- 观察到高可纳耐药性 (54%),特别是在 *C. tropicalis* 和 *C. auris* (p < 0.0001) 中.
- 在58%的分离物中检测到强烈的生物膜形成,主要是NAC物种 (p < 0.0001).
- MLST揭示了四个遗传类和29个不同的序列类型.
结论:
- 在这个印度ICU队列中,非白虫*Candida*物种是产生抗可纳的BSI的主要原因.
- 埃奇诺坎丁和沃里可纳表现出良好的活性,而安福特里辛B的MICs较低.
- 迫切需要快速*Candida*物种识别,抗真菌敏感性测试和加强监测,以指导实证治疗和打击抗真菌耐药性.
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