背景:曲霉属引起各种严重的临床疾病,抗真菌耐药性呈上升趋势。本研究旨在评估自实施以来在我们的临床数据库中记录的所有分离株的医院流行病学和抗真菌药物敏感性。
方法:隔离日期的数据,生物样本,患者的年龄和性别,临床设置,和所有曲霉属的抗真菌药敏试验。从临床数据库中提取2015年至2022年的分离数据。赔率趋势的分数测试,采用非参数MannKendall趋势检验和logistic回归分析患病率,发病率,和曲霉属的季节性。solates.
结果:总共1126个曲霉属。对分离株进行了评估。烟曲霉是最普遍的(44.1%),其次是黑曲霉(22.3%),黄曲霉属(17.7%)和土曲霉属(10.6%)。A.Niger在重症监护病房的患病率随着时间的推移而增加(p趋势=0.0051)。总的来说,16(1.5%)对一种唑类化合物不敏感,和108(10.9%)两性霉素B,A.Niger的百分比最高(21.9%)。6月份检测到烟曲霉的风险较高,(OR=2.14,95%CI[1.16;3.98]p=0.016),与1月相比,9月(OR=0.48,95%CI[0.27;0.87]p=0.015)和10月降低(OR=0.39,95%CI[0.21;0.70]p=0.002。与1月相比,黑曲霉在6月份从所有临床样本中分离的风险降低(OR=0.34,95%CI[0.14;0.79]p=0.012)。黄曲霉的季节性趋势显示9月份检测风险较高(OR=2.7,95%CI[1.18;6.18]p=0.019),与1月相比,10月(OR=2.32,95%CI[1.01;5.35]p=0.048)和11月(OR=2.42,95%CI[1.01;5.79]p=0.047)。
结论:这是第一项分析研究,立刻,有关患病率的数据,时间趋势,季节性,所有曲霉属的物种分布和抗真菌药敏谱。在三级护理中心进行为期8年的分离。令人惊讶的是,没有观察到唑抗性随时间的增加。
BACKGROUND: Aspergillus species cause a variety of serious clinical conditions with increasing trend in antifungal resistance. The present study aimed at evaluating hospital epidemiology and antifungal susceptibility of all isolates recorded in our clinical database since its implementation.
METHODS: Data on date of isolation, biological samples, patients\' age and sex, clinical settings, and antifungal susceptibility tests for all Aspergillus spp. isolated from 2015 to 2022 were extracted from the clinical database. Score test for trend of odds, non-parametric Mann Kendall trend test and logistic regression analysis were used to analyze prevalence, incidence, and seasonality of Aspergillus spp. isolates.
RESULTS: A total of 1126 Aspergillus spp. isolates were evaluated. A. fumigatus was the most prevalent (44.1%) followed by A. niger (22.3%), A. flavus (17.7%) and A. terreus (10.6%). A. niger prevalence increased over time in intensive care units (p-trend = 0.0051). Overall, 16 (1.5%) were not susceptible to one azole compound, and 108 (10.9%) to amphotericin B, with A. niger showing the highest percentage (21.9%). The risk of detecting A. fumigatus was higher in June, (OR = 2.14, 95% CI [1.16; 3.98] p = 0.016) and reduced during September (OR = 0.48, 95% CI [0.27; 0.87] p = 0.015) and October as compared to January (OR = 0.39, 95% CI [0.21; 0.70] p = 0.002. A. niger showed a reduced risk of isolation from all clinical samples in the month of June as compared to January (OR = 0.34, 95% CI [0.14; 0.79] p = 0.012). Seasonal trend for A. flavus showed a higher risk of detection in September (OR = 2.7, 95% CI [1.18; 6.18] p = 0.019), October (OR = 2.32, 95% CI [1.01; 5.35] p = 0.048) and November (OR = 2.42, 95% CI [1.01; 5.79] p = 0.047) as compared to January.
CONCLUSIONS: This is the first study to analyze, at once, data regarding prevalence, time trends, seasonality, species distribution and antifungal susceptibility profiles of all Aspergillus spp. isolates over a 8-year period in a tertiary care center. Surprisingly no increase in azole resistance was observed over time.