In:
PLOS Neglected Tropical Diseases, Public Library of Science (PLoS), Vol. 17, No. 4 ( 2023-4-3), p. e0011201-
Abstract:
This study aimed to investigate the influencing factors of delayed clearance of Talaromyces marneffei ( T . marneffei ) in blood culture of patients with acquired immune deficiency syndrome (AIDS) complicated with talaromycosis after antifungal therapy. Methods The patients with AIDS complicated with talaromycosis were retrospectively enrolled, and divided into two groups according to the blood T . marneffei culture results in two weeks after antifungal therapy. The baseline clinical data were collected and the antifungal susceptibility of T . marneffei was tested. Results A total of 190 patients with AIDS and talaromycosis were enrolled, of whom 101 cases remained positive for T . marneffei (Pos-group) while the other 89 cases were negative in blood culture (Neg-group) after two weeks’ antifungal treatment. The Pos-group had a higher baseline Aspartate aminotransferase (AST, 78.5 vs. 105 U/L; P = 0.073) and lower CD4+ T cells level (11 vs. 7 cells/μl; P = 0.061). The percentage of isolates with higher MICs of voriconazole (VOR) and fluconazole (FLU) in the Pos-group were significantly higher than those in the Neg-group ( χ 2 = 12.623, P 〈 0.001 and χ 2 = 9.356, P = 0.002, respectively). By multivariate logistic regression, the MIC value for VOR was identified as the prognostic variable that may influence the clearance of T . marneffei in blood culture after antifungal therapy among AIDS patients with talaromycosis. Conclusions The delayed negative conversion of blood T . marneffei -culture may be associated with some factors especially higher MIC of VOR, indicating the possibility of drug resistance of T . marneffei .
Type of Medium:
Online Resource
ISSN:
1935-2735
DOI:
10.1371/journal.pntd.0011201
DOI:
10.1371/journal.pntd.0011201.g001
DOI:
10.1371/journal.pntd.0011201.g002
DOI:
10.1371/journal.pntd.0011201.t001
DOI:
10.1371/journal.pntd.0011201.t002
DOI:
10.1371/journal.pntd.0011201.t003
DOI:
10.1371/journal.pntd.0011201.t004
DOI:
10.1371/journal.pntd.0011201.s001
DOI:
10.1371/journal.pntd.0011201.s002
DOI:
10.1371/journal.pntd.0011201.s003
DOI:
10.1371/journal.pntd.0011201.s004
DOI:
10.1371/journal.pntd.0011201.r001
DOI:
10.1371/journal.pntd.0011201.r002
DOI:
10.1371/journal.pntd.0011201.r003
DOI:
10.1371/journal.pntd.0011201.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2023
detail.hit.zdb_id:
2429704-5
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