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异常汉逊酵母菌血症

[Hansenula anomala fungemia].

作者信息

Mestroni S C, Bava A J

机构信息

Laboratorio de Micología, Hospital Interzonal General de Agudos (HIGA) San Martín, Cátedra de Micología y Parasitología, Facultad de Ciencias Exactas, Universidad Nacional de La Plata, La Plata, Argentina.

出版信息

Rev Argent Microbiol. 2003 Jan-Mar;35(1):54-6.

Abstract

We communicate 5 episodes of fungemia produced by Hansenula anomala (Candida pelliculosa) in 4 adult patients and 1 preterm newborn admitted in different wards of the HIGA San Martín of La Plata City during a 13 month period. The isolates were achieved by culture of blood obtained by venipuncture (5/5) and from catheter (2/5) and were processed with BacTAlert system and lysis-centrifugation method. API 32 C system achieved the identification of the isolated yeasts. Among the patients, treatments with antibiotics (5/5) and corticoids (2/5), catheters (3/5), previous surgical procedures and surgical wounds (2/5), prematurely (1/5) and neutropenia (1/5) were present as predisposing factors of fungemia. Three out of the 5 episodes evolved favorably and the remaining 2 patients died in spite of the antifungal treatment. The diagnosis of 4 out of 5 cases in a brief lapse (3 months), and 2 simultaneously in 2 different wards, as well as the lack of other isolates of H. anomala in our Hospital, before and after of the studied period, suggests the possibility of an outbreak. We claim that H. anomala is an emergent fungal pathogen that must be taken into account as etiological agent of fungemia, fundamentally in patients with different predisposing factors.

摘要

我们报告了在13个月期间,拉普拉塔市圣马丁HIGA医院不同病房收治的4名成年患者和1名早产儿中,由异常汉逊酵母(膜醭假丝酵母)引起的5例真菌血症。分离株通过静脉穿刺采集的血液培养(5/5)和导管培养(2/5)获得,并采用BacTAlert系统和裂解离心法进行处理。API 32 C系统实现了对分离出的酵母的鉴定。在这些患者中,使用抗生素(5/5)、皮质类固醇(2/5)、导管(3/5)、既往手术操作和手术伤口(2/5)、早产(1/5)和中性粒细胞减少(1/5)作为真菌血症的易感因素。5例中有3例病情好转,其余2例患者尽管接受了抗真菌治疗仍死亡。5例中有4例在短时间内(3个月)确诊,2例同时在2个不同病房确诊,且在研究期间前后我们医院没有其他异常汉逊酵母分离株,这表明可能存在疫情暴发。我们认为异常汉逊酵母是一种新兴的真菌病原体,必须作为真菌血症的病原体加以考虑,尤其是在有不同易感因素的患者中。

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