Infección del torrente sanguíneo por Candida glabrata en una unidad de cuidados intensivos neonatales con prescripción de profilaxis con fluconazol

IF 1.5 4区生物学 Q4 MYCOLOGY Revista Iberoamericana De Micologia Pub Date : 2020-07-01 DOI:10.1016/j.riam.2020.06.002

Juan Carlos Lona-Reyes , Larissa María Gómez-Ruiz , Araceli Cordero-Zamora , Mariana Chávez-Rodríguez , Juan Antonio Gallegos-Marín , Denisse Sinaí Jiménez-Hernández

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引用次数: 3

Abstract

Background

Candida glabrata is an emerging pathogen with the ability to develop tolerance and resistance to azole antifungals, which creates uncertainty about the usefulness of antifungal prophylaxis in newborns.

Aims

The aim of this study was to describe the factors associated with C. glabrata infection in a NICU that uses prophylaxis with fluconazole.

Methods

A case-control study paired by gestational age was designed and conducted at the Civil Hospital of Guadalajara Dr. Juan I. Menchaca. Newborns with C. glabrata infection were studied and for each one a matched control was selected by gestational age. Odds ratios (OR) were estimated with 95% confidence intervals (95% CI) and McNemar test for contrast of hypothesis was applied.

Results

Twenty-one infected patients were identified, from whom 66.7% were male; the median gestational age was 31.5 weeks. Increased risk of infection with C. glabrata was observed when there was a prescription of more than one antimicrobial scheme (OR 21, 95% CI, 1.23 - 358.3; p = 0.006) and also among patients with surgical comorbidities (OR 8, 95% CI 1.01 - 63.9; p = 0.04). During the study period, exposure to fluconazole showed no difference in the risk of infection.

Conclusions

Neonates with more than one antimicrobial regimen and those with surgical comorbidities had a higher risk of C. glabrata infection.

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新生儿重症监护病房使用氟康唑预防的光滑念珠菌血流感染

背景:光念珠菌是一种新兴的病原体，具有对唑类抗真菌药物产生耐受性和耐药性的能力，这给新生儿抗真菌预防的有效性带来了不确定性。目的本研究的目的是描述在使用氟康唑预防的NICU中与光滑棘球蚴感染相关的因素。方法在瓜达拉哈拉市立医院Juan I. Menchaca医生设计并进行了一项按胎龄配对的病例对照研究。研究了患有光棘球蚴感染的新生儿，并根据胎龄选择了一个匹配的对照。比值比(OR)以95%置信区间(95% CI)估计，采用McNemar假设对比检验。结果共发现感染病例21例，其中男性占66.7%;中位胎龄为31.5周。当处方中有一种以上的抗菌方案时，观察到光斑梭菌感染的风险增加(OR 21, 95% CI, 1.23 - 358.3;p = 0.006)以及手术合并症患者(OR 8, 95% CI 1.01 - 63.9;p = 0.04)。在研究期间，暴露于氟康唑对感染风险没有影响。结论服用一种以上抗菌药物的患者及有手术合并症的患者有较高的光棘球蚴感染风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista Iberoamericana De Micologia MYCOLOGY-

CiteScore

1.90

自引率

0.00%

发文量

审稿时长

81 days

期刊介绍： Revista Iberoamericana de Micología (Ibero-American Journal of Mycology) is the official journal of the Asociación Española de Micología, Asociación Venezolana de Micología and Asociación Argentina de Micología (The Spanish, Venezuelan, and Argentinian Mycology Associations). The Journal gives priority to publishing articles on studies associated with fungi and their pathogenic action on humans and animals, as well as any scientific studies on any aspect of mycology. The Journal also publishes, in Spanish and in English, original articles, reviews, mycology forums, editorials, special articles, notes, and letters to the editor, that have previously gone through a scientific peer review process.