Montejo Miguel
Unidad de Enfermedades Infecciosas, Hospital Universitario de Cruces, Universidad del País Vasco-Euskal Herriko Unibertsitatea, Baracaldo, Vizcaya, España.
Rev Iberoam Micol. 2011 Jul-Sep;28(3):120-3. doi: 10.1016/j.riam.2011.06.003.
Despite advances made in the last decades, invasive fungal infections (IFI) continue to be a major cause of morbidity and mortality in solid organ transplant recipients. The most common pathogens causing IFI are Candida species, followed by Aspergillus and Cryptococcus. A shift in the epidemiology of IFI has been reported in the last few years. Non-Candida albicans Candida species and non-Aspergillus filamentous moulds have been increasingly observed in transplant patients. A change in the IFI onset time has also been described recently. In the RESITRA (Spanish Network of Infection in Transplantation) study, at least 50% of invasive aspergillosis (IA) infections and 40% of invasive Candida infections had been observed after 180 days of transplant. Some cases of cryptococcal infection, traditionally considered as a late onset infection, have been observed in the early post transplant period. Mortality due to IFI is still high, particularly in patients with IA. However, the progressive improvement achieved in diagnosis and prevention of IFI has led to a lower mortality rate.
尽管在过去几十年里取得了进展,但侵袭性真菌感染(IFI)仍然是实体器官移植受者发病和死亡的主要原因。引起IFI最常见的病原体是念珠菌属,其次是曲霉菌和隐球菌。近年来,IFI的流行病学已发生转变。在移植患者中,非白色念珠菌属念珠菌和非曲霉菌丝状霉菌越来越常见。最近还描述了IFI发病时间的变化。在RESITRA(西班牙移植感染网络)研究中,至少50%的侵袭性曲霉病(IA)感染和40%的侵袭性念珠菌感染在移植180天后被观察到。一些传统上被认为是迟发性感染的隐球菌感染病例在移植后早期也有发现。IFI导致的死亡率仍然很高,尤其是IA患者。然而,IFI诊断和预防方面的逐步改善已使死亡率降低。