Palabiyikoğlu I, Oral M, Tulunay M
Laboratory of Clinical Bacteriology, Medical Faculty of Anakara University, Ankara, Turkey.
J Hosp Infect. 2001 Mar;47(3):239-42. doi: 10.1053/jhin.2000.0897.
The diagnosis of pulmonary candidosis is controversial. We undertook a prospective study on 50 mechanically ventilated (>48 h) patients who were hospitalized (>72 h) in the intensive care unit (ICU) with the aim of assessing the incidence of the isolation of Candida species from endotracheal aspirates (EA). Patients were categorized as individuals already colonized with Candida spp. on admission, individuals becoming colonized during hospitalization, or patients with no colonization. Patients in the ICU were hospitalized for a mean of 23 days. The percentage of patients already colonized with Candida was low (six of 50; 12%), the incidence of Candida isolation from EA in critically ill, mechanically ventilated patients in ICU was also low (six of 50; 12%). Age, duration of hospitalization, pre-treatment with antimicrobials or immunosuppressive agents and occurrence of underlying disease were not risk factors in our study. Both antifungal usage and neutropenia were more common in already colonized patients. No risk factors were determined for patients colonized during hospitalization. As all the isolates identified were C. albicans. It appears that at present, colonization and/or infection by more resistant Candida species is not a problem in our unit.
肺念珠菌病的诊断存在争议。我们对50例在重症监护病房（ICU）接受机械通气（>48小时）且住院时间超过72小时的患者进行了一项前瞻性研究，目的是评估从气管内吸出物（EA）中分离出念珠菌属的发生率。患者被分为入院时已被念珠菌属定植的个体、住院期间定植的个体或未定植的患者。ICU中的患者平均住院23天。已被念珠菌定植的患者比例较低（50例中有6例；12%），ICU中重症机械通气患者从EA中分离出念珠菌的发生率也较低（50例中有6例；12%）。在我们的研究中，年龄、住院时间、抗菌药物或免疫抑制剂的预处理以及基础疾病的发生均不是危险因素。在已定植的患者中，抗真菌药物的使用和中性粒细胞减少更为常见。对于住院期间定植的患者，未确定危险因素。由于所有鉴定出的分离株均为白色念珠菌。目前看来，在我们科室，更具耐药性的念珠菌属的定植和/或感染不是问题。
