非白色念珠菌是儿童癌症患者念珠菌血症最常见的病因。
Non-albicans Candida is the most common cause of candidemia in pediatric cancer patients.
作者信息
Mullen C A, Abd El-Baki H, Samir H, Tarrand J J, Rolston K V
机构信息
Department of Pediatrics, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
出版信息
Support Care Cancer. 2003 May;11(5):321-5. doi: 10.1007/s00520-003-0453-9. Epub 2003 Mar 11.
GOALS
Candidemia is a serious infection that can severely complicate the care of children with cancer. We sought to determine the spectrum of Candida species in children with cancer, since effective therapy may depend on the species involved.
PATIENTS AND METHODS
A retrospective review of candidemia episodes in our pediatric oncology patients over a 9-year period was conducted. During this period azole prophylaxis was not routine in this group.
RESULTS
38 episodes of candidemia were identified: C. albicans 29%, C. tropicalis 26%, C. parapsilosis 24%, C. krusei 8%, C. glabrata 8%, and C. lusitaniae 5%. Non-albicans Candida was common in patients not receiving azole prophylaxis. Species typically susceptible to azoles were common among patients not using azoles. Death attributed to the fungal infection occurred in 21% of episodes, with nearly all the deaths occurring in patients with C. albicans and C. tropicalis.
CONCLUSIONS
C. albicans is not the predominant species in pediatric oncology patients experiencing candidemia, even in azole-naive patients.
目标
念珠菌血症是一种严重感染，可使癌症患儿的治疗严重复杂化。由于有效治疗可能取决于所涉及的念珠菌种类，我们试图确定癌症患儿中念珠菌的种类范围。
患者与方法
对我们儿科肿瘤患者9年期间的念珠菌血症发作进行回顾性研究。在此期间，该组未常规使用唑类预防药物。
结果
共确定38例念珠菌血症发作：白色念珠菌占29%，热带念珠菌占26%，近平滑念珠菌占24%，克柔念珠菌占8%，光滑念珠菌占8%，葡萄牙念珠菌占5%。非白色念珠菌在未接受唑类预防的患者中很常见。在未使用唑类药物的患者中，通常对唑类敏感的菌种很常见。21%的发作中出现了因真菌感染导致的死亡，几乎所有死亡都发生在白色念珠菌和热带念珠菌感染的患者中。
结论
即使在未使用过唑类药物的患者中，白色念珠菌也不是发生念珠菌血症的儿科肿瘤患者中的主要菌种。
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