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BMC Infect Dis ; 19(1): 939, 2019 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-31699043


BACKGROUND: Invasive candidiasis (IC) is the most common invasive fungal infection. The epidemiology of IC in hospitalized patients has been widely investigated in many metropolitan cities; however, little information from medium and small cities is known. METHODS: A 5-year retrospective study was carried out to analyze the prevalence, species distribution, antifungal susceptibility, risk factors and mortality of inpatients with invasive Candida infection in a regional tertiary teaching hospital in Southwest China. RESULTS: A total of 243 inpatients with invasive Candida infection during the five-year study period were identified, with a mean annual incidence of 0.41 cases per 1000 admissions and a 30-day mortality rate of 12.3%. The species distributions of Candida albicans, Candida glabrata, Candida tropicalis, Candida krusei, Candida parapsilosis and other Candida species was 45.3, 30.0, 15.2, 4.9, 2.1 and 2.5%, respectively. The total resistance rates of fluconazole (FCA), itraconazole (ITR) and voriconazole (VRC) were 18.6, 23.1 and 18.5%, respectively. Respiratory dysfunction, pulmonary infection, cardiovascular disease, chronic/acute renal failure, mechanical ventilation, abdominal surgery, intensive care in adults, septic shock and IC due to C. albicans were associated with 30-day mortality (P < 0.05) according to the univariate analyses. Respiratory dysfunction [odds ratio (OR), 9.80; 95% confidence interval (CI), 3.24-29.63; P < 0.001] and IC due to C. albicans (OR, 3.35; 95% CI, 1.13-9.92; P = 0.029) were the independent predictors of 30-day mortality. CONCLUSIONS: This report shows that the incidence and mortality rates are lower and that the resistance rates to azoles are higher in medium and small cities than in large cities and that the species distributions and risk factors in medium and small cities are different from those in large cities in China. It is necessary to conduct epidemiological surveillance in medium and small cities to provide reference data for the surveillance of inpatients with IC infections.

Antifúngicos/farmacologia , Candida/efeitos dos fármacos , Candidíase Invasiva/diagnóstico , Adolescente , Adulto , Idoso , Candida/isolamento & purificação , Candida/fisiologia , Candidíase Invasiva/epidemiologia , Candidíase Invasiva/mortalidade , China/epidemiologia , Feminino , Hospitais de Ensino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida , Adulto Jovem
Diagn Microbiol Infect Dis ; 78(3): 268-70, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24359931


Twenty-nine Pseudomonas aeruginosa isolates, which are resistant to carbapenems but susceptible to ceftazidime or/and cefepime, were recovered from our hospital from July 2011 to October 2011. The results of Western blotting showed that the OprD was reduced or lost. None of the 29 clinical isolates produced carbapenemases, extended-spectrum ß-lactamases, or Ambler class C ß-lactamases enzymes by the modified 3-dimensional test. The sequencing of oprD for these isolates showed that there are multiple point mutations, large fragment substitutions, deletions, and insertions. It showed that the expression of oprD decreased while mexA and mexX increased by real-time reverse transcriptase-PCR. These results suggested that the loss of OprD and overexpression of mexXY-OprM and mexAB-OprM are associated with carbapenem resistance in cephalosporin-susceptible Pseudomonas aeruginosa.

Carbapenêmicos/farmacologia , Cefalosporinas/farmacologia , Farmacorresistência Bacteriana Múltipla/genética , Porinas/genética , Pseudomonas aeruginosa/efeitos dos fármacos , Proteínas da Membrana Bacteriana Externa/genética , Proteínas de Bactérias , Sequência de Bases , China , DNA Bacteriano/isolamento & purificação , Humanos , Testes de Sensibilidade Microbiana , Dados de Sequência Molecular , Porinas/metabolismo , Pseudomonas aeruginosa/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Análise de Sequência de DNA , beta-Lactamases