AI Article Synopsis
- The study investigates antifungal susceptibility and infection patterns in ICU patients, focusing on the issue of rising antifungal resistance.
- Researchers conducted antifungal susceptibility tests and genetic analysis on 234 isolates, revealing low genetic diversity and notable mutations linked to echinocandin resistance.
- Findings indicate that prolonged ICU stays, APACHE-II scores, previous antifungal treatments, and lung disease significantly increase the risk of antifungal resistant infections, emphasizing the need for ongoing monitoring in ICU settings.
Article Abstract
Background: The increasing incidence and high mortality rate of infection in ICU patients is an important issue. Therefore, it is imperative to investigate the antifungal susceptibility profiles and epidemiological characteristics in local regions.
Methods: Herein, antifungal susceptibility testing was conducted to determine the minimum inhibitory concentrations (MICs) of eight antifungal drugs. Multilocus sequence typing (MLST) was used to study the strain genotype, geographical distribution, and susceptibility to antifungal agents among isolates. The mechanism of echinocandin resistance was explored by sequencing the and genes (encoding 1,3-β-D-glucan synthases) of echinocandin-resistant strains. Moreover, we further investigated the clinical manifestations and the various risk factors of patients infected with in the ICU.
Results: We selected 234 C isolates from 234 patients in the ICU randomly for the follow-up study. Cross-resistance was found among the ICU isolates. Analysis using MLST showed that the genetic diversity among the isolates was low. Furthermore, sequence type showed no correlation with the antifungal resistance profiles, but was associated with geographical distribution. We also revealed novel mutations in FKS1 (S629P) and FKS2 (W1497stop) that mediated high-level echinocandin resistance (MIC >8 µg/mL). More than 14 days' stay in ICU (P=0.007), Acute Physiology and Chronic Health Evaluation II (APACHE-II) score (P=0.024), prior antifungal exposure (P=0.039) and lung disease (P=0.036) were significantly associated with antifungal resistant/non-wild-type infection.
Conclusion: Our study shed light on the antifungal susceptibility, molecular epidemiology, and clinical risk factors of in the ICU of a Chinese Tertiary Hospital. Importantly, we revealed the molecular mechanism of echinocandin resistance. These results highlight the significance of continued surveillance in ICUs and provide data support for the treatment of in clinics.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11491434 | PMC |
| http://dx.doi.org/10.3389/fcimb.2024.1455145 | DOI Listing |
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