Prevalence, Species Distribution and Resistance of Candidemia in Pediatric and Adult Patients in a Northeast Italy University Hospital.

IF 4.2 2区 生物学 Q2 MICROBIOLOGY Journal of Fungi Pub Date : 2024-10-10 DOI:10.3390/jof10100707
Silvia Meneghello, Giulia Bernabè, Giuseppe Di Pietra, Sarah Di Sopra, Claudia Del Vecchio, Anna Maria Cattelan, Ignazio Castagliuolo, Paola Brun
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Abstract

Candidemia and invasive candidiasis (IC) are causes of morbidity and mortality in healthcare settings, with notable differences between children and adults. Understanding the species distribution and antimicrobial susceptibility profiles of clinical isolates can guide empiric therapy in patients at risk of IC. This study investigated the incidence and antifungal susceptibility patterns of yeasts involved in IC in pediatric and adult patients from 2019 to 2023. The average incidence of IC was 0.715 per 1000 patients, increasing over the study period; infants had the highest incidence rates. Over half of the IC episodes occurred in intensive care units (ICUs). Non-albicans Candida (NAC) species represented the most frequently isolated species in adults and children (55.96% and 50.0%, respectively), with the prevalence of C. parapsilosis (26.45% and 14.7%, respectively), N. glabratus (14.97% and 8.82%, respectively) and C. tropicalis (4.36% and 2.94%, respectively). C. lusitaniae was identified in 14.7% of pediatric IC cases. In NAC species, antifungal resistance has also increased over the five years of the study: 69.12% were resistant to azoles and 7.35% were resistant to micafungin. Resistance was higher in pediatric patients. Our study highlights differences in IC characteristics between pediatric and adult populations and emphasizes the importance of targeted antifungal stewardship in ICU patients with NAC invasive infections.

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意大利东北部一家大学医院小儿和成人念珠菌病的发病率、菌种分布和耐药性。
念珠菌血症和侵袭性念珠菌病(IC)是导致医疗机构发病和死亡的原因,儿童和成人之间存在明显差异。了解临床分离株的菌种分布和抗菌药敏感性特征可以指导对有可能患上念珠菌病的患者进行经验性治疗。本研究调查了2019年至2023年儿童和成人患者中IC酵母菌的发病率和抗真菌药敏模式。IC的平均发病率为每1000名患者中0.715例,在研究期间不断上升;婴儿的发病率最高。超过一半的 IC 发生在重症监护室(ICU)。成人和儿童中最常分离出的念珠菌是非白色念珠菌(NAC),分别占 55.96% 和 50.0%,其中副丝状念珠菌(C. parapsilosis)(分别占 26.45% 和 14.7%)、光滑念珠菌(N. glabratus)(分别占 14.97% 和 8.82%)和热带念珠菌(C. tropicalis)(分别占 4.36% 和 2.94%)最为常见。在 14.7% 的儿科 IC 病例中发现了 C. lusitaniae。在这项研究的五年间,南澳大利亚菌种对抗真菌药物的耐药性也有所上升:69.12%的人对唑类产生耐药性,7.35%的人对米卡芬净产生耐药性。儿科患者的耐药性更高。我们的研究凸显了儿科和成人群体在感染性真菌病特征方面的差异,并强调了对患有非典型肺炎侵袭性感染的重症监护病房患者进行有针对性的抗真菌管理的重要性。
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来源期刊
Journal of Fungi
Journal of Fungi Medicine-Microbiology (medical)
CiteScore
6.70
自引率
14.90%
发文量
1151
审稿时长
11 weeks
期刊介绍: Journal of Fungi (ISSN 2309-608X) is an international, peer-reviewed scientific open access journal that provides an advanced forum for studies related to pathogenic fungi, fungal biology, and all other aspects of fungal research. The journal publishes reviews, regular research papers, and communications in quarterly issues. Our aim is to encourage scientists to publish their experimental and theoretical results in as much detail as possible. Therefore, there is no restriction on paper length. Full experimental details must be provided so that the results can be reproduced.
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