Literature review of 1 case of triazole-and echinocandin-resistant tropical Pseudohyphomycetes bloodstream infection
OBJECTIVE To report a case of triazole-and echinocandin-resistant tropical Pseudohyphae bloodstream infection.METHODS The clinical data,therapeutic process,and pethogenetic data of a patient with bloodstream infection caused by triazole-and echinocandin-resistant Pseudomonas tropicalis admitted to the First Affiliated Hospital of Sun Yat-sen University in Oct.2023 were retrospectively analyzed.The ERG11 and FKS genes of the strain were also analyzed for mutations,in order to investigate the resistance mechanisms to triazole and echino-candin drugs.RESULTS The patient developed neutropenia on the 20th day after admission,and after adjustment of antimicrobials,the infection indexes remained persistently elevated,and two G test results of ≥600 pg/ml were obtained,and both urine and blood culture samples were cultured for Pseudohyphae,which was resistant to both triazole and echinocandin.The antifungal agents were subsequently adjusted to meropenem in combination with micafungin and polymyxin,but the patient's condition remained critical,the prognosis was poor,and the patient's family gave up the treatment.The strain detected double mutations at bases A395T and C461T in the ERG11 gene and a mutation at base T1960C in the FKS1 gene.CONCLUSION It is necessary to pay attention to the multi-drug resistance of Pseudohyphae tropica,and enhance the surveillance of antifungal drug resistance.
万方数据
维普
