Jain Akansha, Jain Shubham, Rawat Swati
SAFE Institute of Pharmacy, Gram Kanadiya, Indore, India.
J Pharm Bioallied Sci. 2010 Oct;2(4):314-20. doi: 10.4103/0975-7406.72131.
The incidence of fungal infections is increasing at an alarming rate, presenting an enormous challenge to healthcare professionals. This increase is directly related to the growing population of immunocompromised individuals especially children resulting from changes in medical practice such as the use of intensive chemotherapy and immunosuppressive drugs. Although healthy children have strong natural immunity against fungal infections, then also fungal infection among children are increasing very fast. Virtually not all fungi are pathogenic and their infection is opportunistic. Fungi can occur in the form of yeast, mould, and dimorph. In children fungi can cause superficial infection, i.e., on skin, nails, and hair like oral thrush, candida diaper rash, tinea infections, etc., are various types of superficial fungal infections, subcutaneous fungal infection in tissues under the skin and lastly it causes systemic infection in deeper tissues. Most superficial and subcutaneous fungal infections are easily diagnosed and readily amenable to treatment. Opportunistic fungal infections are those that cause diseases exclusively in immunocompromised individuals, e.g., aspergillosis, zygomycosis, etc. Systemic infections can be life-threatening and are associated with high morbidity and mortality. Because diagnosis is difficult and the causative agent is often confirmed only at autopsy, the exact incidence of systemic infections is difficult to determine. The most frequently encountered pathogens are Candida albicans and Aspergillus spp. But other fungi such as non-albicans Candida spp. are increasingly important.
真菌感染的发生率正以惊人的速度上升,给医疗保健专业人员带来了巨大挑战。这种增长与免疫功能低下人群尤其是儿童数量的增加直接相关,这是由医学实践的变化导致的,如强化化疗和免疫抑制药物的使用。尽管健康儿童对真菌感染有强大的天然免疫力,但儿童中的真菌感染也在迅速增加。实际上,并非所有真菌都是致病的,它们的感染具有机会性。真菌可以以酵母、霉菌和双态形式出现。在儿童中,真菌可引起浅表感染,即在皮肤、指甲和头发上,如鹅口疮、念珠菌尿布疹、癣感染等,这些都是各种类型的浅表真菌感染,皮下真菌感染发生在皮肤下的组织中,最后它会导致深部组织的全身感染。大多数浅表和皮下真菌感染很容易诊断,并且易于治疗。机会性真菌感染是指仅在免疫功能低下个体中引起疾病的感染,例如曲霉病、接合菌病等。全身感染可能危及生命,且与高发病率和死亡率相关。由于诊断困难,病原体往往仅在尸检时才能确认,因此全身感染的确切发生率难以确定。最常见的病原体是白色念珠菌和曲霉菌属。但其他真菌,如非白色念珠菌属,也越来越重要。