Marchetti Oscar, Bille Jacques, Fluckiger Ursula, Eggimann Philippe, Ruef Christian, Garbino Jorge, Calandra Thierry, Glauser Michel-Pierre, Täuber Martin George, Pittet Didier
Infectious Diseases Service, Department of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Clin Infect Dis. 2004 Feb 1;38(3):311-20. doi: 10.1086/380637. Epub 2004 Jan 14.
Candida species are among the most common bloodstream pathogens in the United States, where the emergence of azole-resistant Candida glabrata and Candida krusei are major concerns. Recent comprehensive longitudinal data from Europe are lacking. We conducted a nationwide survey of candidemia during 1991-2000 in 17 university and university-affiliated hospitals representing 79% of all tertiary care hospital beds in Switzerland. The number of transplantations and bloodstream infections increased significantly (P<.001). A total of 1137 episodes of candidemia were observed: Candida species ranked seventh among etiologic agents (2.9% of all bloodstream isolates). The incidence of candidemia was stable over a 10-year period. C. albicans remained the predominant Candida species recovered (66%), followed by C. glabrata (15%). Candida tropicalis emerged (9%), the incidence of Candida parapsilosis decreased (1%), and recovery of C. krusei remained rare (2%). Fluconazole consumption increased significantly (P<.001). Despite increasing high-risk activities, the incidence of candidemia remained unchanged, and no shift to resistant species occurred.
念珠菌属是美国最常见的血流病原体之一，其中耐唑类的光滑念珠菌和克柔念珠菌的出现是主要关注点。欧洲近期缺乏全面的纵向数据。我们在瑞士17所大学及大学附属医院开展了一项1991 - 2000年期间念珠菌血症的全国性调查，这些医院占瑞士所有三级护理医院床位的79%。移植手术数量和血流感染显著增加（P<0.001）。共观察到1137例念珠菌血症发作：念珠菌属在病原体中排名第七（占所有血流分离株的2.9%）。念珠菌血症的发病率在10年期间保持稳定。白色念珠菌仍然是分离出的主要念珠菌种（66%），其次是光滑念珠菌（15%）。热带念珠菌出现（9%），近平滑念珠菌的发病率下降（1%），克柔念珠菌的分离率仍然很低（2%）。氟康唑的消耗量显著增加（P<0.001）。尽管高危活动增加，但念珠菌血症的发病率保持不变，且未出现向耐药菌种的转变。
