Pan-Echinocandin-Resistant Candida glabrata Bloodstream Infection Complicating COVID-19: A Fatal Case Report

被引：68

作者：

Posteraro, Brunella ^{[1
,2
]}

Torelli, Riccardo ^{[3
]}

Vella, Antonietta ^{[3
]}

Leone, Paolo Maria ^{[2
]}

De Angelis, Giulia ^{[3
]}

De Carolis, Elena ^{[3
]}

Ventura, Giulio ^{[3
,4
]}

Sanguinetti, Maurizio ^{[1
,3
]}

Fantoni, Massimo ^{[3
,4
]}

机构：

[1] Univ Cattolica Sacro Cuore, Clin Intensivol & Perioperatorie, Dipartimento Sci Biotecnol Base, I-00168 Rome, Italy

[2] Fdn Policlin Univ A Gemelli IRCCS, Dipartimento Sci Gastroenterol Endocrinometab & N, I-00168 Rome, Italy

[3] Fdn Policlin Univ A Gemelli IRCCS, Dipartimento Sci Lab & Infettivol, I-00168 Rome, Italy

[4] Univ Cattolica Sacro Cuore, Dipartimento Sicurezza & Bioet, I-00168 Rome, Italy

来源：

JOURNAL OF FUNGI | 2020年 / 6卷 / 03期

关键词：

SARS-CoV-2; coinfection; diabetes; bloodstream infection; Candida glabrata; echinocandin resistance; FKS mutation; INVASIVE CANDIDIASIS; FKS2; SUSCEPTIBILITY; MUTATIONS; OUTCOMES; FAILURE; GLUCOSE; RISK;

D O I：

10.3390/jof6030163

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

Coinfections with bacteria or fungi may be a frequent complication of COVID-19, but coinfections with Candida species in COVID-19 patients remain rare. We report the 53-day clinical course of a complicated type-2 diabetes patient diagnosed with COVID-19, who developed bloodstream infections initially due to methicillin-resistant Staphylococcus aureus, secondly due to multidrug-resistant Gram-negative bacteria, and lastly due to a possibly fatal Candida glabrata. The development of FKS-associated pan-echinocandin resistance in the C. glabrata isolated from the patient after 13 days of caspofungin treatment aggravated the situation. The patient died of septic shock shortly before the prospect of receiving potentially effective antifungal therapy. This case emphasizes the importance of early diagnosis and monitoring for antimicrobial drug-resistant coinfections to reduce their unfavorable outcomes in COVID-19 patients.

引用

页码：1 / 11

页数：11

共 55 条

[1]

Agnelli C, 2019, REV ESP QUIM, V32, P395

[2] Increasing Echinocandin Resistance in Candida glabrata: Clinical Failure Correlates With Presence of FKS Mutations and Elevated Minimum Inhibitory Concentrations [J].