背景:血管进入装置(VAD),即外周VAD(PVAD)和中心静脉VAD(CVAD),在重症监护病房(ICU)和非ICU设置中都至关重要。然而,VAD安置存在风险,尤其是导管相关性血流感染(CRBSI)。念珠菌属。是CRBSI中常见的病原体,然而其临床和微生物学特征,尤其是在非ICU环境中,未被充分挖掘。
方法:我们进行了单中心,2021年5月1日至2023年9月1日在LuigiSacco医院进行的回顾性观察研究。我们回顾了非ICU成人CVAD和PVAD患者的医疗记录。人口统计数据,临床和实验室结果,VAD放置,并收集CRBSI事件。统计学分析比较念珠菌属。CRBSI和细菌CRBSI组。
结果:在1518例患者的1802例VAD中,确定了54例CRBSI,和念珠菌属。在30.9%的事件中被隔离。CRBSI的患病率为3.05%,念珠菌属。占0.94%。CRBSI的发生率为2.35/1000导管天,与白色念珠菌和非白色念珠菌在0.47和0.26每1000个导管天,分别为念珠菌属的患者。CRBSI有更频繁的SARS-CoV-2感染,COVID-19肺炎,和低蛋白血症.
结论:在COVID-19大流行期间,念珠菌属。是我们中心CRBSI的一个显著原因,强调考虑念珠菌属的重要性。在CRBSI疑似病例中,包括那些在非ICU设置和PVAD。
BACKGROUND: Vascular access devices (VADs), namely peripheral VADs (PVADs) and central venous VADs (CVADs), are crucial in both intensive care unit (ICU) and non-ICU settings. However, VAD placement carries risks, notably catheter-related bloodstream infections (CRBSIs). Candida spp. is a common pathogen in CRBSIs, yet its clinical and microbiological characteristics, especially in non-ICU settings, are underexplored.
METHODS: We conducted a monocentric, retrospective observational study at Luigi Sacco Hospital from 1 May 2021 to 1 September 2023. We reviewed medical records of non-ICU adult patients with CVADs and PVADs. Data on demographics, clinical and laboratory results, VAD placement, and CRBSI occurrences were collected. Statistical analysis compared Candida spp. CRBSI and bacterial CRBSI groups.
RESULTS: Out of 1802 VAD placements in 1518 patients, 54 cases of CRBSI were identified, and Candida spp. was isolated in 30.9% of episodes. The prevalence of CRBSI was 3.05%, with Candida spp. accounting for 0.94%. Incidence rates were 2.35 per 1000 catheter days for CRBSI, with Candida albicans and Candida non-albicans at 0.47 and 0.26 per 1000 catheter days, respectively-patients with Candida spp. CRBSI had more frequent SARS-CoV-2 infection, COVID-19 pneumonia, and hypoalbuminemia.
CONCLUSIONS: During the COVID-19 pandemic, Candida spp. was a notable cause of CRBSIs in our center, underscoring the importance of considering Candida spp. in suspected CRBSI cases, including those in non-ICU settings and in those with PVADs.