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The epidemiology of non-Candida yeast isolated from blood: The Asia Surveillance Study

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单位: [1]Kaohsiung Med Univ Hosp, Dept Internal Med, Div Infect Dis, Kaohsiung, Taiwan [2]Kaohsiung Med Univ Hosp, Dept Lab Med, Kaohsiung, Taiwan [3]Kaohsiung Med Univ, Coll Med, Sch Med, Kaohsiung, Taiwan [4]Kaohsiung Med Univ, Grad Inst Med, Kaohsiung, Taiwan [5]Singapore Gen Hosp, Dept Infect Dis, Singapore, Singapore [6]Postgrad Inst Med Educ & Res PGIMER, Dept Med Microbiol, Chandigarh, India [7]Natl Taiwan Univ Hosp & Coll Med, Dept Internal Med, Div Infect Dis, Taipei, Taiwan [8]Sterling Hosp, Dept Infect Dis, Ahmadabad, Gujarat, India [9]Peking Univ, Res Ctr Med Mycol, Hosp 1, Dept Dermatol, Beijing, Peoples R China [10]Ramathibodi Hosp, Fac Med, Dept Med, Dept Infect Dis, Bangkok, Thailand [11]Peking Union Med Coll Hosp, Dept Infect Dis, Beijing, Peoples R China [12]Chulalongkorn Univ, King Chulalongkorn Mem Hosp, Fac Med, Dept Microbiol, Bangkok, Thailand [13]Singapore Gen Hosp, Dept Pathol, Singapore, Singapore [14]Chang Gung Mem Hosp, Dept Dermatol, Taoyuan, Taiwan [15]Chang Gung Univ, Coll Med, Taoyuan, Taiwan [16]Natl Taiwan Univ, Coll Publ Hlth, Grad Inst Epidemiol & Prevent Med, Taipei, Taiwan [17]Natl Hlth Res Inst, Natl Inst Infect Dis & Vaccinol, Miaoli, Taiwan [18]Chinese Acad Med Sci, Peking Union Med Coll Hosp, Dept Clin Lab, Beijing, Peoples R China [19]Peking Univ, Peoples Hosp, Dept Clin Lab, Beijing, Peoples R China [20]Huazhong Univ Sci & Technol, Tongji Hosp, Dept Clin Lab, Wuhan, Hubei, Peoples R China [21]Sichuan Univ, West China Hosp, Dept Clin Lab, Chengdu, Sichuan, Peoples R China [22]Harbin Med Univ, Clin Coll 1, Dept Clin Lab, Harbin, Heilongjiang, Peoples R China [23]Zhejiang Univ, Coll Med, Affiliated Hosp 1, Dept Clin Lab, Hangzhou, Zhejiang, Peoples R China [24]Fudan Univ, Huashan Hosp, Dept Dermatol, Shanghai, Peoples R China [25]Nanjing Gen Hosp Nanjing Mil Commend, Dept Clin Lab, Nanjing, Jiangsu, Peoples R China [26]Sun Yat Sen Univ, Affiliated Hosp 1, Dept Clin Lab, Guangzhou, Guangdong, Peoples R China [27]Univ Hong Kong, Dept Microbiol, Hong Kong, Peoples R China [28]Sanjay Gandhi Postgrad Inst Med Sci, Dept Microbiol, Lucknow, Uttar Pradesh, India [29]Sri Ram Chandra Med Coll & Res Inst, Dept Microbiol, Chennai, India [30]Veteran Gen Hosp, Dept Internal Med, Taichung, Taiwan [31]China Med Univ Hosp, Div Infect Dis, Taichung, Taiwan [32]Buddhist Tzu Chi Gen Hosp, Dept Internal Med, Hualien, Taiwan [33]Bhumibol Adulyadej Hosp, Bangkok, Thailand
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关键词: candidemia echinocandin fungemia presumptive therapy yeast

摘要:
Background Current guidelines recommend echinocandins as first-line therapy for candidemia. However, several non-Candida yeast are non-susceptible to echinocandins (echinocandin non-susceptible yeast, ENSY), including Cryptococcus, Geotrichum, Malassezia, Pseudozyma, Rhodotorula, Saprochaete, Sporobolomyces and Trichosporon. In laboratories that are not equipped with rapid diagnostic tools, it often takes several days to identify yeast, and this may lead to inappropriate presumptive use of echinocandins in patients with ENSY fungemia. The aim of this study was to determine the distribution of ENSY species during a 1-year, laboratory surveillance programme in Asia. Methods Non-duplicate yeast isolated from blood or bone marrow cultures at 25 hospitals in China, Hong Kong, India, Singapore, Taiwan and Thailand were analysed. Isolates were considered to be duplicative if they were obtained within 7 days from the same patient. Results Of 2155 yeast isolates evaluated, 175 (8.1%) were non-Candida yeast. The majority of non-Candida yeast were ENSY (146/175, 83.4%). These included Cryptococcus (109 isolates), Trichosporon (23), Rhodotorula (10) and Malassezia (4). The proportion of ENSY isolates (146/2155, 6.7%) differed between tropical (India, Thailand and Singapore; 51/593, 8.6%) and non-tropical countries/regions (China, Hong Kong and Taiwan; 95/1562, 6.1%, P = 0.038). ENSY was common in outpatient clinics (25.0%) and emergency departments (17.8%) but rare in intensive care units (4.7%) and in haematology-oncology units (2.9%). Cryptococcus accounted for the majority of the non-Candida species in emergency departments (21/24, 87.5%) and outpatient clinics (4/5, 80.0%). Conclusions Isolation of non-Candida yeast from blood cultures was not rare, and the frequency varied among medical units and countries.

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出版当年[2018]版:
大类 | 3 区 医学
小类 | 3 区 皮肤病学 3 区 真菌学
最新[2025]版:
大类 | 2 区 医学
小类 | 2 区 皮肤病学 2 区 真菌学
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出版当年[2017]版:
Q1 DERMATOLOGY Q2 MYCOLOGY
最新[2023]版:
Q1 DERMATOLOGY Q2 MYCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

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第一作者单位: [1]Kaohsiung Med Univ Hosp, Dept Internal Med, Div Infect Dis, Kaohsiung, Taiwan [2]Kaohsiung Med Univ Hosp, Dept Lab Med, Kaohsiung, Taiwan [3]Kaohsiung Med Univ, Coll Med, Sch Med, Kaohsiung, Taiwan [4]Kaohsiung Med Univ, Grad Inst Med, Kaohsiung, Taiwan
通讯作者:
通讯机构: [7]Natl Taiwan Univ Hosp & Coll Med, Dept Internal Med, Div Infect Dis, Taipei, Taiwan [17]Natl Hlth Res Inst, Natl Inst Infect Dis & Vaccinol, Miaoli, Taiwan [*1]Natl Taiwan Univ Hosp & Coll Med, Dept Med, Taipei, Taiwan
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