Myoken Yoshinari, Kyo Tai-ichi, Sugata Tatsumi, Murayama Somay Yamagata, Mikami Yuzuru
Haematologica. 2006 Feb;91(2):287-8.
A 7-year retrospective analysis of candidemia in patients with hematologic malignancies demonstrated that ten patients, who received itraconazole and fluconazole during neutropenia, developed breakthrough fungemia caused by fluconazole-resistant Candida albicans (C. albicans) with decreased susceptibility to voriconazole. Eight of these ten patients died of candidemia despite amphotericin B administration. Karyotype analysis of C. albicans isolates revealed that all isolates were genetically unrelated? Our findings suggest that blood isolates of C. albicans in neutropenic patients receiving azoles could be azole cross-resistant, and that the patients should be treated by other antifungals such as echinocandins.
一项对血液系统恶性肿瘤患者念珠菌血症的7年回顾性分析表明，10名在中性粒细胞减少期间接受伊曲康唑和氟康唑治疗的患者发生了由对氟康唑耐药的白色念珠菌引起的突破性真菌血症，且对伏立康唑的敏感性降低。尽管给予了两性霉素B治疗，但这10名患者中有8名死于念珠菌血症。对白色念珠菌分离株的核型分析表明，所有分离株在基因上均无关联。我们的研究结果表明，接受唑类药物治疗的中性粒细胞减少患者的血液中分离出的白色念珠菌可能对唑类药物具有交叉耐药性，这些患者应使用棘白菌素等其他抗真菌药物进行治疗。
