ABSTRACT
Objective To evaluate the ability of MALDI-TOF MS in identification of the yeast isolated from clinical specimens.Methods 387 strains of yeasts were tested.All the strains were from clinical specimen and identified by VITEK MS and API ID 32C system at the same time.Sequencing of the internal transcribed spacer (ITS) regions of ribosomal DNA was used as the reference method in the analysis of a total of 387 yeast isolates.The accuracy of detected results was analyzed by the X2 test.Results The identification accuracy rates of VITEK MS, API ID 32C were respectively 97.7% and 93.0%.The difference was statistically significant (X2=9.439, P=0.002).There was no statistical significance between MALDI-TOF and ITS sequencing.Conclusion MALDI-TOF is a rapid simple and accurate method which is identified to species level in identification of yeasts.
ABSTRACT
Objective To investigate the clinical features and prognostic factors of nosocomially acquired candidemia.Methods A retrospective analysis was conducted for hospitalized patients with nosocomial candidemia between January 2012 and December 2014 at the First Affiliated Hospital of Anhui Medical University.The univariate and multivariate Logistic regression analyses were used to determine the prognostic factors of candidemia.Results A total of 92 patients were diagnosed with nosocomially acquired candidemia.The most common pathogen was Candida glabrata (C.glabrata,39/92,42.4％),followed by Candida albicans (C.albicans,30/92,32.6％),then Candida krusei (C.krusei,7/92,7.6％),Candida tropicalis (C.tropicalis,5/92,5.4％),Candida parapsilosis (C.parapsilosis,4/92,4.4％) and other Candida spp.(7/92,7.6％).The sensitivity rates of Candida spp.strains against flucytosine,amphotericin B,voriconazole,fluconazole and itraconazol were 100.0％,98.9％,92.4％,82.6％oo and 77.2％,respectively.The 30-day attributable case fatality rate was 13.0％(12/92).Multivariate Logistic regression analyses indicated that presence of central venous catheter (OR=4.833,95％CI:1.010-23.125,P=0.049),invasive mechanical ventilation (OR=6.075,95％CI:1.144-32.257,P=0.034),and receiving hemodialysis (OR =8.367,95 ％ CI:1.390-50.364,P =0.020)were factors independently correlated with increased mortality.Conclusions The pathogens causing nosocomially acquired candidemia are mainly C.glabrata,C.albicans and C.krusei.The drug susceptibility of Candida spp.varies among fluconazole,itraconazol voriconazole.The resistant rates of Candida spp.against voriconazole,fluconazole and itraconazol are different.The presence of central venous catheter,invasive mechanical ventilation and receiving hemodialysis are factors independently correlated with increased mortality.