耳念珠菌与新型冠状病毒共感染研究的Meta分析

Research of coinfection of Candida auris with severe acute respiratory syndrome coronavirus 2 :a meta analysis

目的 研究耳念珠菌感染与新型冠状病毒(简称新冠病毒)共感染的防控,探讨新冠病毒感染住院患者继发感染耳念珠菌首次检测报告阳性时限。方法 检索自2019年12月1日-2022年12月31日,在PubMed、Web of Science、中国知网、万方数据知识服务平台、维普和中国生物医学文献数据库收录的相关文献,进行Meta分析。结果 符合纳入标准的英文文献30篇(未检索到中文文献),研究内容多聚焦于耳念珠菌感染的流行病学、真菌血症风险因素、医院暴发和防控等;对其中9篇60例新冠感染患者共感染耳念珠菌且有明确微生物鉴定结果的文献进行Meta分析,结果提示:耳念珠菌合并检出率为19.4%(95%CI:12.1%~27.8%);新冠病毒感染患者入院后10~20 d首次检测报告阳性率最高,该时间段与入院时间最短的组间差异有统计学意义。结论 新冠病毒感染大流行期间,国外对耳念珠菌的研究关注度高于国内,医院内感染的预防和控制策略继续向全方位、多专业、多学科发展。

OBJECTIVE To study the prevention and control of Candida auris(C. auris) and severe acute respiratory syndrome coronavirus 2 co-infection and explore the time limit for the first positive test of secondary infection of C. auris in hospitalized patients with COVID-19. METHODS A systematic search of PubMed, Web of Science, CNKI, Wanfang, VIP, and China biology medicine database for relevant literature on C. auris was conducted from Dec 1, 2019, to Dec 31, 2022, and meta-analysis were performed. RESULTS Thirty english publications(Chinese literature was not retrieved) that met the inclusion criteria mostly focused on the epidemiology of co-infection with C. auris, risk factors for fungemia, hospital outbreaks, and prevention and control. Meta-analysis was performed on nine articles in which 60 patients with COVID-19 were co-infected with C. auris and microbial identification results suggested that the detection rate of C. auris co-infection was 19.4%(95% CI:12.1%-27.8%);the positive rate of the first detection was the highest between 10 and 20 days after admission, and the difference between group during this period and the group with the shortest admission time was statistically significant. CONCLUSION Foreign research on C. auris in the context of COVID-19 has received more attention, and strategies for the prevention and control of hospital-acquired infections continue to develop in a comprehensive, multispecialty, and multidisciplinary manner.