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A Ten-year Retrospective Study of invasive candidiasis in a Tertiary Hospital in Beijing

Biomedical and Environmental Sciences 2021年第10期34卷 773-788页

作者： YANG Zhi Hui SONG Ying Gai LI Ruo Yu Department of Dermatology and Venerology Beijing Key Laboratory of Molecular Diagnosis of DermatosesNational Clinical Research Center for Skin and Immune DiseasesNMPA Key Laboratory for Quality Control and Evaluation of CosmeticsPeking University First HospitalBeijing 100034China

Objective This study aimed to evaluate the epidemiological,clinical and mycological characteristics of invasive candidiasis(IC)in China.Methods A ten-year retrospective study including 183 IC episodes was conducted in a tertiary hospital in Beijing,China.Results The overall incidence of IC from 2010–2019 was 0.261 episodes per 1,000 discharges.Candidemia(71.0%)was the major infective pattern;70.3%of the patients tested positive for Candida spp.colonization before IC and the median time to develop an invasive infection after colonization was13.5 days(interquartile range:4.5–37.0 days).Candida albicans(45.8%)was the most prevalent species,followed by Candida parapsilosis(19.5%),Candida glabrata(14.2%)and Candida tropicalis(13.7%).C.non-albicans IC was more common in patients with severe anemia(P=0.018),long-term hospitalization(P=0.015),hematologic malignancies(P=0.002),continuous administration of broad-spectrum antibiotics(P<0.001)and mechanical ventilation(P=0.012).In vitro resistance testing showed that11.0%of the Candida isolates were resistant/non-wild type(non-WT)to fluconazole,followed by voriconazole(9.6%),micafungin(3.8%),and caspofungin(2.9%).Fluconazole was the most commonly used drug to initiate antifungal therapy both before and after the proven diagnosis(52.6%and 54.6%,respectively).The 30-day and 90-day all-cause mortality rates were 24.5%and 32.7%,respectively.Conclusion The incidence of IC has declined in the recent five years.C.non-albicans contributed to more than half of the IC cases.Fluconazole can be used as first-line therapy if resistant strains are not prevalent.Prospective,multi-center surveillance of the clinical and mycological characteristics of IC is required.

关键词： invasive candidiasis Epidemiology Risk factors Antifungal resistance Treatment Mortality

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Analysis of Clinical Characteristics and Diagnostic Value of Fungal Serology in Patients with invasive candidiasis

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Open Journal of Medical Microbiology 2020年第4期10卷 222-232页

作者： Heqiu Ruan Weihua Xu Mengjuan Xia Zhichao Ma Shengmiao Fu Xinping Chen Central Laboratory Hainan General Hospital Hainan Hospital Affiliated to The Hainan Medical College Hainan Provincial Key Laboratory of Cell and Molecular Genetic Translational Medicine Haikou China

Objective: To evaluate the diagnostic value of (1 - 3)-β-D glucan and mannan assay for invasive candidiasis. Methods: A retrospective study was conducted on 32 cases in the disease group (18 proven invasive candidiasis and 14 probable invasive candidiasis) and 48 cases in the control group. The subjects were recruited from January 2018 to March 2019 in Clinical Laboratory of Hainan General Hospital. All subjects were detected by (1 - 3)-β-D glucan and mannan assay. Results: The mean concentration of (1 - 3)-β-D glucan in the disease group was 97.45 (43.23, 224.35) pg/ml and it was significantly higher than the mean concentration of the control group which was 49.85(41.91, 56.07) pg/ml (P = 0.005). The mean concentration of mannan in the disease group and the control group were 161.36 (34.96, 224.49) pg/ml and 25.80 (25.00, 29.31) pg/ml, respectively, which were significantly different (P β-D

关键词： invasive candidiasis Mannan (1 - 3)-β-D Glucan Combination of Serological Tests

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Optimization of Dosage Regimen of Rezafungin against <i>Candida spp. </i>Based on Pharmacokinetic/Pharmacodynamic Analysis

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Pharmacology & Pharmacy 2020年第6期11卷 79-84页

作者： Jiuli Hu Junhui Hu Department of Clinic Pharmacy Affiliated of Chengde Medical College Chengde China Department of Pharmacy The Affiliated Hospital of Chengde Medical College Chengde China

invasive candidiasis was the most common nosocomial fungal infection with high morbidity and mortality, which is mainly occurring in immunodeficiency and critical patients. Echinocandins were recommended as first-line drugs for the treatment and prevention of invasive candidiasis. In our study, we aimed to optimize the dosage of Rezafungin against Candida spp. based on pharmacokinetic/pharmacodynamics (PK/PD) analysis. We collected the published data about pharmacokinetic parameters of rezafungin and the MIC distribution of Candida spp. on rezafungin. Monte Carlo simulation was used to calculate probability of target attainment and a cumulative fraction of response to assess the best dosing regimen. The optimal dosage regimen for C. albicans and C. glabrata was 50 mg IV, and the optimal dosage regimen for C.

关键词： invasive candidiasis Rezafungin Pharmacokinetics/Pharmacodynamics Monte Carlo Simulation

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Fluconazole Prophylaxis in Neonates (Non-Systematic) Literature Review

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Pharmacology & Pharmacy 2016年第12期7卷 473-480页

作者： Abdulaziz Almulhim College of Pharmacy University of Arizona Tucson AZ USA

Background: Nosocomial infection remains an important contributing factor for morbidity and mortality in neonates. Coagulase-negative staphylococci have emerged as the predominant pathogens of late onset sepsis. This is followed by staphylococcus aurous, gram negative bacilli, and fungi. Old studies noted that mortality due to candidemia was higher in infants weigh less than 2000 g after being exposed to risk factors. The prophylactic use of fluconazole for the prevention of IC in extremely low birth weight was first reported in 2001. Methods: Current guidelines from Europe and North America that refer to the treatment of fungal infections are included. Literature search was performed using Medline, Scopus and Cochrane Central Register of Controlled Trials through March, 2016. Conclusion: Mortality was not different in early studies. However, recent studies concluded that mortality was reduced in the fluconazole arms. Risk-based approach towards fluconazole prophylaxis seems to be safe and effective.

关键词： invasive candidiasis Neonates Preterm Fluconazole Prophylaxis Central Venous Catheters

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