Department of Internal Medicine II, University of Würzburg Medical Center, Würzburg, Germany.
Med Mycol. 2012 Jan;50(1):50-5. doi: 10.3109/13693786.2011.587211. Epub 2011 Jun 22.
Invasive Candida infections are associated with high morbidity and mortality. Due to an increased incidence in patients with hematological or oncological malignancies, fluconazole prophylaxis became a common practice in many centers in the late 1990s. Until recently, there was insufficient data on the effect of the use of azoles on the incidence of Candida blood stream infections and species distribution. Here we present a single center retrospective study of the epidemiology of Candida blood stream infections in hospitalized patients at a German university medical center from 2003-2009. Twenty-one Candida species were isolated in culture from blood specimens of 20 patients. The annual rate of candidemia approached 1.1 per thousand hospitalizations, during the first 5 years of the survey, but showed a significant increase after 2007. Candida albicans, although still the dominant species, was recovered as the responsible pathogen from only 28.6% of the cases. A high rate of fatal outcomes was noted at 30 days (56%) and 100 days (67%) after the first positive finding of Candida in blood culture. These results underline the clinical significance of this infectious complication, and the need for continuous monitoring for Candida blood stream infections in order to improve the clinical and therapeutic management of this specific patient population.
侵袭性念珠菌感染与高发病率和死亡率相关。由于血液系统或恶性肿瘤患者的发病率增加，氟康唑预防在 20 世纪 90 年代后期成为许多中心的常规做法。直到最近，关于唑类药物的使用对念珠菌血流感染的发生率和物种分布的影响的数据还不够充分。在这里，我们报告了 2003 年至 2009 年期间，德国一所大学医学中心住院患者中念珠菌血流感染的单中心回顾性研究。从 20 名患者的血液标本中培养出了 21 种念珠菌。在调查的前 5 年，念珠菌血症的年发病率接近每千例住院患者 1.1 例，但在 2007 年后显著增加。尽管白色念珠菌仍然是主要的病原体，但只有 28.6%的病例中分离出其为致病病原体。首次在血培养中发现念珠菌后的 30 天（56%）和 100 天（67%），死亡率较高。这些结果强调了这种感染性并发症的临床意义，以及为改善该特定患者人群的临床和治疗管理，持续监测念珠菌血流感染的必要性。
