Rodrigues Gustavo da Silva, de Faria Rodrigo Rosa Ubatuba, Guazzelli Lucina Silva, Oliveira Flávio de Mattos, Severo Luiz Carlos
Laboratório SANI, Passo Fundo, Brasil.
Rev Iberoam Micol. 2006 Jun;23(2):85-9. doi: 10.1016/s1130-1406(06)70019-5.
Twenty two cases of nosocomial infection caused by Trichosporon asahii, detected during a period of six years (1999-2005) is described. The patients were predominantly males with an average age of 47.3 years-old. The predominant diseases in the study group were respiratory insufficiency, cancer, diabetes, chronic renal insufficiency, cirrhosis and AIDS. The main predisposing conditions were antibiotic therapy, mechanical ventilation, urethral catheterization, catheter, corticoids, transplant, immunosuppressive therapy, chemotherapy, granulocytopenia, surgical procedures and continuous ambulatory peritoneal dialysis. The most used antifungal drugs were fluconazole and amphotericin B. In some cases several antifungals were administered. Five patients did not receive antifungal treatment, and one patient received granulocyte colony stimulating factor (G-CSF). Nine patients showed clinical improvement, nine died and the progress of four patients is unknown. T. asahii is an emergent pathogen in patients with immunodeficiency and its presence in these type hosts can not be considered colonization, as there is an important risk of invasive infection. So, in susceptible patients to develop trichosporonosis it is advisable to take into consideration this disease especially in intensive clinical care units.
本文描述了在六年期间(1999 - 2005年)检测到的22例由阿萨希毛孢子菌引起的医院感染病例。患者以男性为主,平均年龄为47.3岁。研究组中主要疾病为呼吸功能不全、癌症、糖尿病、慢性肾功能不全、肝硬化和艾滋病。主要的易感因素为抗生素治疗、机械通气、尿道插管、导尿管、皮质类固醇、移植、免疫抑制治疗、化疗、粒细胞减少、外科手术和持续性非卧床腹膜透析。最常用的抗真菌药物为氟康唑和两性霉素B。在某些病例中使用了几种抗真菌药物。5例患者未接受抗真菌治疗,1例患者接受了粒细胞集落刺激因子(G - CSF)。9例患者临床症状改善,9例死亡,4例患者病情转归不明。阿萨希毛孢子菌是免疫缺陷患者中的一种新兴病原体,其在这类宿主中的存在不能被视为定植,因为存在侵袭性感染的重要风险。因此,在易发生毛孢子菌病的易感患者中,尤其是在重症监护病房,应特别考虑这种疾病。