Rodero L, Davel G, Soria M, Vivot W, Córdoba S, Canteros C E, Saporiti A
Departamento Micología, INEI, ANLIS, Dr. Carlos G. Malbrán, Vélez Sarsfield 563 (1281), Ciudad Autńoma de Buenos Aires, Argentina.
Rev Argent Microbiol. 2005 Oct-Dec;37(4):189-95.
The incidence of candidemia has increased approximately 500% in high-complexity hospitals. A change in the spectrum of Candida infections due to species other than Candida albicans has also been detected. Between April 1999 and April 2000 a multicenter study was performed in order to determine the species distribution associated to candidemias in Argentina and the susceptibility profile of the isolates to the current antifungal drugs. Thirty six institutions have participated. All the 265 yeast strains isolated from blood cultures were identified by morphological, physiological, and biochemical tests. The antifungal susceptibility testing of isolates was performed based on the reference NCCLS procedure. The distribution of species was: Candida albicans (40.75%), Candida parapsilosis (28.67%), Candida tropicalis (15.84%), Candida famata (3.77%), Cryptococcus neoformans (3.77%), Candida glabrata (2.64%), and others (4.53%). Most of the isolates were susceptible to amphotericin B, fluconazole and itraconazole. Mortality associated to the fungemia by yeasts episodes (n=265) was 30%, lower than results previously determined (33-54%). The mortality percentage in patients who received antifungal therapy versus patients without treatment was 26.3% and 47%, respectively.
在高复杂性医院中,念珠菌血症的发病率增加了约500%。此外,还发现白色念珠菌以外的其他念珠菌感染谱发生了变化。1999年4月至2000年4月期间,开展了一项多中心研究,以确定阿根廷念珠菌血症相关的菌种分布以及分离株对当前抗真菌药物的敏感性概况。有36家机构参与。从血培养中分离出的所有265株酵母菌株均通过形态学、生理学和生化试验进行鉴定。分离株的抗真菌药敏试验按照美国国家临床实验室标准委员会(NCCLS)的参考程序进行。菌种分布情况如下:白色念珠菌(40.75%)、近平滑念珠菌(28.67%)、热带念珠菌(15.84%)、法塔念珠菌(3.77%)、新生隐球菌(3.77%)、光滑念珠菌(2.64%)以及其他菌种(4.53%)。大多数分离株对两性霉素B、氟康唑和伊曲康唑敏感。酵母引起的真菌血症(n = 265)相关死亡率为30%,低于先前确定的结果(33%-54%)。接受抗真菌治疗的患者与未接受治疗的患者的死亡率分别为26.3%和47%。