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IR@PKUHSC  > 北京大学第一临床医学院  > 皮肤性病科  > 期刊论文
学科主题: 临床医学
题名:
Invasive candidiasis in intensive care units in China: a multicentre prospective observational study
作者: Guo, Fengmei1; Yang, Yi1; Kang, Yan2; Zang, Bin3; Cui, Wei4; Qin, Bingyu5; Qin, Yingzhi6; Fang, Qiang7; Qin, Tiehe8; Jiang, Dongpo9; Li, Weiqin10; Gu, Qin11; Zhao, Hongsheng12; Liu, Dawei13; Guan, Xiangdong14; Li, Jianguo15; Ma, Xiaochun16; Yu, Kaijiang17; Chan, Dechang18; Yan, Jing19; Tang, Yaoqing20; Liu, Wei21; Li, Ruoyu21; Qiu, Haibo1; China-SCAN Team1
关键词: invasive Candida infection ; Candida albicans ; ICUs ; antifungal
刊名: JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
发表日期: 2013-07-01
DOI: 10.1093/jac/dkt083
卷: 68, 期:7, 页:1660-1668
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Infectious Diseases ; Microbiology ; Pharmacology & Pharmacy
研究领域[WOS]: Infectious Diseases ; Microbiology ; Pharmacology & Pharmacy
关键词[WOS]: FUNGAL-INFECTIONS ; BROTH MICRODILUTION ; ANTIFUNGAL THERAPY ; RISK-FACTORS ; CANDIDEMIA ; MANAGEMENT ; EPIDEMIOLOGY ; OUTCOMES ; FLUCONAZOLE ; MORTALITY
英文摘要:

To describe the epidemiology, microbiology and management of invasive Candida infection (ICI) in intensive care units (ICUs) in China.

A multicentre, prospective, observational study in 67 hospital ICUs across China. Patients were 18 years old with clinical signs of infection and at least one of the following diagnostic criteria: (i) histopathological, cytopathological or microscopic confirmation of yeast cells from a normally sterile site; (ii) at least one peripheral blood culture positive for Candida; and (iii) positive Candida culture from a normally sterile site. The China-SCAN study is registered with ClinicalTrials.gov (NCT T01253954).

ICI incidence was 0.32 (306 patients/96060 ICU admissions) and median time between ICU admission and diagnosis was 10.0 days. Candida albicans was the most prevalent single isolate (41.8 of patients), although non-albicans species accounted for the majority of infections. Diagnostic confirmation was based solely on at least one positive blood culture in 290 (94.8) cases. Treatment was initiated after diagnostic confirmation in 166/268 (61.9) patients. Triazoles (62.7) and echinocandins (34.2) were the most commonly used antifungal agents; first-line therapy was typically fluconazole (37.7). The median duration of antifungal therapy was 14 days. The mortality rate was 36.6 (112/306); the median time between diagnosis and death was 14.5 days. Mortality was higher in older individuals, those with solid tumours, those with recent invasive mechanical ventilation and those with a higher sequential organ failure assessment score at diagnostic confirmation. Susceptibility to first-line antifungals was associated with lower mortality than dose-dependent susceptibility or complete resistance (P0.008).

More infections were caused by non-albicans than Candida albicans strains. The majority of patients were treated only after diagnostic confirmation, rather than empirically. First-line antifungal susceptibility was associated with lower mortality.

语种: 英语
项目资助者: Merck Sharp Dohme China
WOS记录号: WOS:000320452200031
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/50875
Appears in Collections:北京大学第一临床医学院_皮肤性病科_期刊论文

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作者单位: 1.Sichuan Univ, West China Hosp, Chengdu 610064, Peoples R China
2.Jinling Hosp, Nanjing, Jiangsu, Peoples R China
3.Nantong Univ, Affiliated Hosp, Nantong, Peoples R China
4.Wuhan Univ, Zhongnan Hosp, Wuhan 430072, Peoples R China
5.China Med Univ, Hosp 1, Shenyang, Peoples R China
6.China Med Univ, Shengjing Hosp, Shenyang, Peoples R China
7.Henan Prov Peoples Hosp, Zhengzhou, Peoples R China
8.Tianjin Third Cent Hosp, Tianjin, Peoples R China
9.Guangdong Gen Hosp, Guangzhou, Guangdong, Peoples R China
10.Daping Hosp, Chongqing, Peoples R China
11.Harbin Med Univ, Affiliated Hosp 2, Harbin, Peoples R China
12.Shanghai Changzheng Hosp, Shanghai, Peoples R China
13.Zhejiang Hosp, Hangzhou, Zhejiang, Peoples R China
14.Southeast Univ, Sch Med, Nanjing Zhongda Hosp, Nanjing, Jiangsu, Peoples R China
15.Zhejiang Univ, Sch Med, Affiliated Hosp 2, Hangzhou 310003, Zhejiang, Peoples R China
16.Zhejiang Univ, Sch Med, Affiliated Hosp 1, Hangzhou 310003, Zhejiang, Peoples R China
17.Nanjing Univ, Sch Med, Drum Tower Hosp, Nanjing 210008, Jiangsu, Peoples R China
18.Beijing Union Med Coll Hosp, Beijing, Peoples R China
19.Sun Yat Sen Univ, Affiliated Hosp 1, Guangzhou 510275, Guangdong, Peoples R China
20.Shanghai Jiao Tong Univ, Sch Med, Rui Jin Hosp, Shanghai 200030, Peoples R China
21.Peking Univ, Hosp 1, Res Ctr Med Mycol, Beijing 100871, Peoples R China

Recommended Citation:
Guo, Fengmei,Yang, Yi,Kang, Yan,et al. Invasive candidiasis in intensive care units in China: a multicentre prospective observational study[J]. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY,2013,68(7):1660-1668.
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