https://scholars.lib.ntu.edu.tw/handle/123456789/589087
標題: | The epidemiology, genotypes, antifungal susceptibility of Trichosporon species, and the impact of voriconazole on Trichosporon fungemia patients | 作者: | Kuo S.-H. Lu P.-L. YEE-CHUN CHEN Ho M.-W. Lee C.-H. Chou C.-H. Lin S.-Y. |
關鍵字: | Antifungal susceptibility; Fungemia; Trichosporon; Trichosporon asahii; Voriconazole | 公開日期: | 2021 | 出版社: | Elsevier B.V. | 卷: | 120 | 期: | 9 | 起(迄)頁: | 1686-1694 | 來源出版物: | Journal of the Formosan Medical Association | 摘要: | Background/purpose: Invasive Trichosporon infections are emerging, but association of different therapeutic management of Trichosporon fungemia and clinical outcomes were rarely reported. This study investigates the epidemiology, species distribution and genotypes of trichosporonosis in Taiwan, and identified the predictors of clinical outcomes in patients with Trichosporon fungemia. Methods: Strains collected from four medical centers in Taiwan, during 2010–2018. Species identification was confirmed by sequencing of IGS1 region, and antifungal susceptibility was performed using Sensititre YeastOne panel. Results: Among 115 isolates, Trichosporon asahii was the leading species (73.0%), followed by Trichosporon dermatis (11.3%), Trichosporon faecales (6.1%), and Trichosporon montevideense (5.2%). Of the 84 T. asahii isolates, genotype 1 was the predominant (41.7%). High fluconazole minimal inhibitory concentration (MICs,≧8 μg/mL) were observed for 70.2% T. asahii isolates and 16.1% non-asahii Trichosporon isolates. Posaconazole and voriconazole possess the most potent antifungal activity against all Trichosporon isolates, with geometric mean values of 0.251 μg/mL and 0.111 μg/mL, respectively. Fifty-three isolates collected from blood cultures, and 42 patients with fungemia enrolled for the Kaplan–Meier plot which revealed that voriconazole treatment had a significantly better survival rate compared with those without (p = 0.042). In multivariate analysis, source control (odds ratio [OR]: 0.13 95%CI [confidence interval]: 0.02–0.83, p = 0.031) and voriconazole use (OR: 0.11 95%CI: 0.02–0.74, p = 0.023) are independent predictors of 14-day mortality. Conclusion: This is the largest series of Trichosporon fungemia up till the present moment. Voriconazole therapy and source control play important roles in 14-day mortality. ? 2020 |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85098123619&doi=10.1016%2fj.jfma.2020.12.007&partnerID=40&md5=0cb46e48726978c778ea3e1f550418a6 https://scholars.lib.ntu.edu.tw/handle/123456789/589087 |
ISSN: | 0929-6646 | DOI: | 10.1016/j.jfma.2020.12.007 | SDG/關鍵字: | amphotericin B; anidulafungin; caspofungin; fluconazole; flucytosine; itraconazole; micafungin; posaconazole; ribosome DNA; voriconazole; antifungal agent; fungal DNA; voriconazole; abscess; adult; antifungal susceptibility; Article; bacterial strain; bacterium isolate; bloodstream infection; body fluid; Candida albicans; catheter infection; Charlson Comorbidity Index; chronic kidney failure; clinical article; clinical outcome; comorbidity; controlled study; drug potency; female; fungemia; genotype; hematologic malignancy; human; male; malignant neoplasm; middle aged; minimum inhibitory concentration; mortality; multicenter study; pathogenesis; respiratory tract secretion; retrospective study; Sanger sequencing; secretion (process); septic shock; Sequential Organ Failure Assessment Score; solid malignant neoplasm; species distribution; species identification; strain identification; superficial abscess; survival rate; Taiwan; Trichosporon; Trichosporon asahii; Trichosporon dermatis; Trichosporon faecales; Trichosporon montevideense; trichosporonosis; Basidiomycetes; fungemia; genetics; genotype; microbial sensitivity test; Antifungal Agents; Basidiomycota; DNA, Fungal; Fungemia; Genotype; Humans; Microbial Sensitivity Tests; Trichosporon; Voriconazole |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。