Schelenz Silke
Department of Microbiology, Norfolk and Norwich University Hospital, Norwich NR2 3TX, UK.
J Antimicrob Chemother. 2008 Jan;61 Suppl 1:i31-4. doi: 10.1093/jac/dkm430.
In the last two decades, Candida has emerged as an important opportunistic pathogen. Patients admitted to the intensive care unit (ICU) are particularly susceptible to this infection because of the severity of their underlying illness and the excess use of medical and surgical interventions. The frequent use of antibiotics, central venous catheters and other intravascular devices as well as poor gut motility or abdominal surgery place these patients at high risk of infection, which contributes to the morbidity and mortality of the already critically ill patient. Early recognition and appropriate management of invasive candidiasis are therefore important. This article addresses important management issues such as the role of screening for Candida colonization, the use of prophylaxis and the choice of antifungal agents for the treatment of presumed and proven invasive candidiasis in the adult ICU setting.
在过去二十年中，念珠菌已成为一种重要的机会性病原菌。入住重症监护病房（ICU）的患者因其基础疾病的严重性以及大量使用医疗和外科干预措施，特别容易受到这种感染。频繁使用抗生素、中心静脉导管和其他血管内装置，以及肠道蠕动不良或腹部手术，使这些患者处于高感染风险中，这增加了本就危重症患者的发病率和死亡率。因此，早期识别和适当管理侵袭性念珠菌病很重要。本文讨论了重要的管理问题，如念珠菌定植筛查的作用、预防措施的使用以及在成人ICU环境中治疗疑似和确诊侵袭性念珠菌病时抗真菌药物的选择。
