Abstract:
BACKGROUND:Candidemia is a common cause of nosocomial bloodstream infections, resulting in high morbidity and mortality. This study was conducted to describe the epidemiology, species distribution, antifungal susceptibility patterns and outcomes of candidemia in a large regional tertiary referral hospital. METHODS:A retrospective surveillance study of patients with candidemia was conducted at Singapore General Hospital between July 2012 and December 2015. In addition, incidence densities and species distribution of candidemia episodes were analysed from 2008 to 2015. RESULTS:In the period of 2012 to 2015, 261 candidemia episodes were identified. The overall incidence was 0.14/1000 inpatient-days. C. glabrata (31.4%), C. tropicalis (29.9%), and C. albicans (23.8%) were most commonly isolated. The incidence of C. glabrata significantly increased from 2008 to 2015 (Coefficient 0.004, confidence interval 0-0.007, p = 0.04). Fluconazole resistance was detected primarily in C. tropicalis (16.7%) and C. glabrata (7.2%). fks mutations were identified in one C. albicans and one C. tropicalis. Candidemia episodes caused by C. tropicalis were more commonly encountered in patients with haematological malignancies (p = 0.01), neutropenia (p < 0.001) and higher SAPS II scores (p = 0.02), while prior exposure to echinocandins was associated with isolation of C. parapsilosis (p = 0.001). Echinocandins (73.3%) were most commonly prescribed as initial treatment. The median (range) time to initial treatment was 1 (0-9) days. The 30-day in-hospital mortality rate was 49.8%. High SAPS II score (Odds ratio, OR 1.08; 95% confidence interval, CI 1.05-1.11) and renal replacement therapy (OR 5.54; CI 2.80-10.97) were independent predictors of mortality, while drain placement (OR 0.44; CI 0.19-0.99) was protective. CONCLUSIONS:Decreasing azole susceptibilities to C. tropicalis and the emergence of echinocandin resistance suggest that susceptibility patterns may no longer be sufficiently predicted by speciation in our institution. Candidemia is associated with poor outcomes. Strategies optimising antifungal therapy, especially in the critically-ill population, should be explored.
journal_name
Antimicrob Resist Infect Controljournal_title
Antimicrobial resistance and infection controlauthors
Teo JQ,Candra SR,Lee SJ,Chia SY,Leck H,Tan AL,Neo HP,Leow KW,Cai Y,Ee PLR,Lim TP,Lee W,Kwa ALdoi
10.1186/s13756-017-0184-1subject
Has Abstractpub_date
2017-03-11 00:00:00pages
27issn
2047-2994pii
184journal_volume
6pub_type
杂志文章abstract:Background:Although alcohol-based surgical hand preparation offers potential advantages over the traditional surgical scrubbing technique, implementing it may be challenging due to resistance of surgeons in changing their practice. We aimed to implement alcohol-based surgical hand preparation in the hospital setting ev...
journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
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journal_title:Antimicrobial resistance and infection control
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-017-0171-6
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abstract::We characterised 227 Staphylococcus aureus isolates from retail food and food handlers' gloves samples obtained through food surveillance and risk assessment studies between 2011 and 2014. Of 227 isolates, five (2.2%) were methicillin-resistant and belonged to sequence types ST80 (n = 3) and ST6 (n = 2). All five isol...
journal_title:Antimicrobial resistance and infection control
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doi:10.1186/s13756-017-0255-3
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abstract:BACKGROUND:Due to limited therapeutic options and their association with high mortality and morbidity, carbapenem-non-susceptible Acinetobacter spp. (CNA) are of significant public health importance. This study aimed to describe current epidemiological trends of CNA proportions in Europe and to identify factors that ar...
journal_title:Antimicrobial resistance and infection control
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abstract:BACKGROUND:Surgical site infections (SSI) are one of the most common healthcare associated infections in the low-middle income countries. Data on incidence and risk factors for SSI following surgeries in general and Obstetric and Gynecological surgeries in particular are scare. This study set out to identify risk facto...
journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-017-0223-y
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journal_title:Antimicrobial resistance and infection control
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
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journal_title:Antimicrobial resistance and infection control
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journal_title:Antimicrobial resistance and infection control
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doi:10.1186/s13756-020-00874-8
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doi:10.1186/s13756-020-00794-7
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abstract::The WHO SAVE LIVES: Clean Your Hands global hand hygiene campaign, launched in 2009 and celebrated annually on the 5th of May, features specific calls to action seeking to increase engagement from stakeholders' collaborations in hand hygiene improvement. WHO calls on everyone to be inspired by the global movement towa...
journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-019-0511-9
更新日期:2019-03-28 00:00:00
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/2047-2994-2-5
更新日期:2013-02-07 00:00:00
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/2047-2994-1-37
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章,多中心研究
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abstract:OBJECTIVE:To determine the effect of exposure to remnants of a phagemid-containing E. coli, killed by treatment with a propanol-based hand rub, on antimicrobial resistance in E. coli isolates. METHODS:An in vitro model was developed in which a clinical E. coli isolate (EUR1) was exposed to remnants of an E. coli K-12 ...
journal_title:Antimicrobial resistance and infection control
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doi:10.1186/s13756-020-00708-7
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journal_title:Antimicrobial resistance and infection control
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journal_title:Antimicrobial resistance and infection control
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/2047-2994-1-32
更新日期:2012-10-09 00:00:00
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-020-00814-6
更新日期:2020-10-26 00:00:00
abstract:Background:Acinetobacter baumannii causes frequently nosocomial infections worldwide. Its ability to survive on dry surfaces facilitates its spread and the persistence of endemic situations, especially in the intensive care units (ICUs).The objective of this paper is to describe a multicomponent intervention program de...
journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-019-0658-4
更新日期:2019-12-04 00:00:00
abstract:BACKGROUND:Very low birthweight (VLBW) newborns on neonatal intensive care units (NICU) are at increased risk for developing central venous catheter-associated bloodstream infections (CVC BSI). In addition to the established intrinsic risk factors of VLBW newborns, it is still not clear which process and structure para...
journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/2047-2994-2-11
更新日期:2013-04-04 00:00:00
abstract:Background:The methicillin-resistant clone Staphylococcus capitis NRCS-A, involved in sepsis in neonatal intensive care units (NICUs) worldwide, is able to persist and spread in NICUs, suggesting the presence of reservoirs inside each setting. The purpose of the present study was to identify these reservoirs and to inv...
journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-019-0616-1
更新日期:2019-10-17 00:00:00
abstract:BACKGROUND:While multi-drug resistant organisms (MDRO) are a global phenomenon, there are significant regional differences in terms of prevalence. Traveling to countries with a high MDRO prevalence increases the risk of acquiring such an organism. In this study we determined risk factors for MDRO colonization among pat...
journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-015-0071-6
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-020-00755-0
更新日期:2020-06-16 00:00:00
abstract:Background:Antibiotic resistance, is often conferred by the presence of antibiotic resistance genes. This study aimed to investigate the relationship between tetracycline resistance (Tet-R) and genotype in 31 Lactobacillus isolates from caries-active patients. Methods:The tetracycline susceptibility of Lactobacillus i...
journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/s13756-019-0483-9
更新日期:2019-02-04 00:00:00
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journal_title:Antimicrobial resistance and infection control
pub_type: 杂志文章
doi:10.1186/2047-2994-1-12
更新日期:2012-03-16 00:00:00