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重症监护病房中的光滑念珠菌血症

Candida glabrata fungaemia in intensive care units.

作者信息

Ruan S-Y, Lee L-N, Jerng J-S, Yu C-J, Hsueh P-R

机构信息

Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.

出版信息

Clin Microbiol Infect. 2008 Feb;14(2):136-40. doi: 10.1111/j.1469-0691.2007.01892.x. Epub 2007 Nov 28.

Abstract

Candidaemia is increasingly important in intensive care units (ICUs). Compared with Candida albicans fungaemia, the impact of C. glabrata fungaemia on ICU patients is not well-known. The aim of this study was to investigate the clinical features, the antifungal susceptibility and the treatment outcomes of C. glabrata fungaemia in ICU patients. The medical records of ICU patients with candidaemia between 2000 and 2005 were reviewed retrospectively, and antifungal susceptibility testing was performed for isolates of C. glabrata. Among 147 episodes of candidaemia occurring in adult ICUs, C. glabrata was the second most common species and accounted for 45 (30%) episodes of candidaemia. The incidence of C. glabrata fungaemia was 1.3/1000 ICU admissions. Fluconazole resistance was found in 11% of C. glabrata isolates. The 30-day all-cause mortality rate was 58%. Therapeutic regimens containing amphotericin B were associated with better outcome. Despite higher fluconazole resistance, C. glabrata candidaemia was not associated with greater mortality than non-glabrata candidaemia in the ICU setting.

摘要

念珠菌血症在重症监护病房(ICU)中的重要性日益凸显。与白色念珠菌血症相比,光滑念珠菌血症对ICU患者的影响尚不为人所知。本研究的目的是调查ICU患者中光滑念珠菌血症的临床特征、抗真菌药敏性及治疗结果。对2000年至2005年间ICU念珠菌血症患者的病历进行回顾性分析,并对光滑念珠菌分离株进行抗真菌药敏试验。在成人ICU发生的147例念珠菌血症中,光滑念珠菌是第二常见的菌种,占念珠菌血症病例的45例(30%)。光滑念珠菌血症的发病率为1.3/1000例ICU入院患者。11%的光滑念珠菌分离株对氟康唑耐药。30天全因死亡率为58%。含两性霉素B的治疗方案预后较好。尽管光滑念珠菌对氟康唑耐药性较高,但在ICU环境中,光滑念珠菌血症与非光滑念珠菌血症相比,死亡率并未更高。

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