Myoken Yoshinari
Department of Oral Surgery, Hiroshima Red Cross and Atomic Bomb Survivors Hospital.
Nihon Ishinkin Gakkai Zasshi. 2009;50(4):225-8. doi: 10.3314/jjmm.50.225.
A proportional increase in candidemia due to non-albicans Candida species has been reported worldwide. In our hospital, 36 of 58 candidemia cases were caused by non-albicans Candida species between 1996 and 2007. Candidemia due to non-albicans Candida species is associated with fluconazole(FLCZ)exposure. In our cases, 36 of 36 non-albicans candidemia cases received FLCZ while 18 of 22 albicans candidemia cases received this drug. In general, non-albicans Candida species including C. tropicalis, C. parapsilosis, and C. guilliermondii are susceptible to FLCZ. On the other hand, C. glabrata and C. krusei exhibit decreased susceptibility to FLCZ. Our in vitro susceptibility test revealed the same results as above although C. guilliermondii showed an elevated MIC to FLCZ(4-8 microg/ml). In addition, both C. parapsilosis and C. guilliermondii showed elevated MICs to micafungin (1 microg/ml and 0.5-2 microg/ml, respectively) which is generally useful for non-albicans Candida species.
全球范围内均有报道称,非白色念珠菌所致的念珠菌血症呈比例增加。在我院,1996年至2007年间,58例念珠菌血症病例中有36例由非白色念珠菌引起。非白色念珠菌所致的念珠菌血症与氟康唑(FLCZ)暴露有关。在我们的病例中,36例非白色念珠菌血症病例均接受了氟康唑治疗,而22例白色念珠菌血症病例中有18例接受了该药治疗。一般来说,包括热带念珠菌、近平滑念珠菌和季也蒙念珠菌在内的非白色念珠菌对氟康唑敏感。另一方面,光滑念珠菌和克柔念珠菌对氟康唑的敏感性降低。我们的体外药敏试验得出了与上述相同的结果,尽管季也蒙念珠菌对氟康唑的最低抑菌浓度升高(4-8微克/毫升)。此外,近平滑念珠菌和季也蒙念珠菌对米卡芬净的最低抑菌浓度均升高(分别为1微克/毫升和0.5-2微克/毫升),而米卡芬净通常对非白色念珠菌有效。