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奥默柯达酵母(毕赤酵母)感染:两例病例及文献综述

Infections by the yeast Kodomaea (Pichia) ohmeri: two cases and literature review.

作者信息

Han X Y, Tarrand J J, Escudero E

机构信息

Department of Laboratory Medicine, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX 77030, USA.

出版信息

Eur J Clin Microbiol Infect Dis. 2004 Feb;23(2):127-30. doi: 10.1007/s10096-003-1067-3. Epub 2004 Jan 14.

Abstract

A 14-year-old boy who was neutropenic following chemotherapy for leukemia developed fungemia caused by the yeast Kodomaea ohmeri ( Pichia ohmeri). The infection was cured by catheter removal and the use of fluconazole. A 74-year-old man who had undergone surgeries for a subcutaneous tumor developed polymicrobic cellulitis involving Kodomaea ohmeri. Despite surgical debridement and antibiotic therapy, the patient died of complications. Including these 2 cases, there have been 10 Kodomaea ohmeri infections reported thus far, all occurring in patients with pre-existing conditions. There have been seven cases of fungemia and one case each of peritonitis, funguria, and cellulitis. The treatment employed varied depending on the site/source of infection. Seven patients recovered and three died. The microbiological data available suggest that Kodomaea ohmeri can be identified definitively by biochemical tests and is susceptible to amphotericin B and either susceptible to or dose dependently susceptible to itraconazole and fluconazole.

摘要

一名14岁男孩在白血病化疗后出现中性粒细胞减少,并发由奥默柯达酵母(毕赤酵母)引起的真菌血症。通过拔除导管和使用氟康唑治愈了感染。一名74岁男性因皮下肿瘤接受手术后发生了累及奥默柯达酵母的多菌种蜂窝织炎。尽管进行了手术清创和抗生素治疗,患者仍死于并发症。包括这2例在内,迄今为止共报告了10例奥默柯达酵母感染,均发生在有基础疾病的患者中。有7例真菌血症,腹膜炎、真菌尿和蜂窝织炎各1例。所采用的治疗方法因感染部位/来源而异。7例患者康复,3例死亡。现有微生物学数据表明,奥默柯达酵母可通过生化试验明确鉴定,对两性霉素B敏感,对伊曲康唑敏感或呈剂量依赖性敏感,对氟康唑敏感。

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