Swinne D, Watelle M, Suetens C, Mertens K, Fonteyne P A, Nolard N
Mycology Section, Scientific Institute of Public Health, Brussels, Belgium.
Epidemiol Infect. 2004 Dec;132(6):1175-80. doi: 10.1017/s095026880400295x.
A total of 211 episodes of bloodstream yeast infections in 207 patients, hospitalized in 28 Belgian hospitals participating in a National Surveillance Program, were evaluated. A total of 81% of the patients were more than 50 years of age. Candida albicans was the cause of infections in 55% of patients, 22% were due to C. glabrata and 13% to C. parapsilosis. The most common predisposing factors were antibacterial therapy (42%), residence in an intensive care unit (32.9%) and presence of an intravascular catheter (29.7%). Most patients had more than one predisposing factor. Fluconazole alone or in association with another antifungal agent was the treatment of choice for 89.7% of the cases. In vitro susceptibility testing of the isolates revealed that 99% were susceptible to amphotericin B, 95% to 5-fluorocytosine, 82% to fluconazole and 69% to itraconazole. Resistance to azoles was more common among C. glabrata isolates in the elderly. We conclude that the frequency of C. albicans infection is decreasing in Belgium and this is associated with the emergence of other species, most notably, C. glabrata.
对参与一项国家监测项目的比利时28家医院收治的207例患者中发生的211次血流酵母菌感染发作进行了评估。共有81%的患者年龄超过50岁。白色念珠菌是55%患者感染的病因，光滑念珠菌占22%，近平滑念珠菌占13%。最常见的易感因素是抗菌治疗（42%）、入住重症监护病房（32.9%）和存在血管内导管（29.7%）。大多数患者有不止一种易感因素。单独使用氟康唑或与另一种抗真菌药物联合使用是89.7%病例的治疗选择。对分离株的体外药敏试验显示，99%对两性霉素B敏感，95%对5-氟胞嘧啶敏感，82%对氟康唑敏感，69%对伊曲康唑敏感。老年人的光滑念珠菌分离株中对唑类药物的耐药性更为常见。我们得出结论，比利时白色念珠菌感染的频率正在下降，这与其他菌种的出现有关，最显著的是光滑念珠菌。
