Pemán Javier, Salavert Miguel
Servicio de Microbiología, Hospital Universitario y Politécnico La Fe, Valencia, España. peman
Enferm Infecc Microbiol Clin. 2012 Feb;30(2):90-8. doi: 10.1016/j.eimc.2011.09.004. Epub 2011 Nov 12.
Invasive mycoses associated with high morbidity and mortality rates are increasing among immunocompromised or severely ill patients. Candida, Cryptococcus, Pneumocystis and Aspergillus are most prevalent agents with varying distribution as regards geography, patient condition and hospital units. The latest multicentre candidaemia survey conducted in Spain, showed C. albicans as the most frequently isolated species followed by C. parapsilosis, C. glabrata, C. tropicalis and C. krusei in contrast with other European or American studies where C. glabrata was second in rank. Aspergillus spp. is the leading agent causing invasive mycoses among filamentous fungi followed by Fusarium spp., Scedosporium spp. and zygomycetes. Aspergillus fumigatus is the most common agent in invasive aspergillosis (and azole-resistant isolates have been reported) but in the last few years Aspergillus flavus, Aspergillus nidulans and Aspergillus terreus have been isolated with increasing frequency variable with geographical factors, patients' underlying conditions or previous antifungal treatments.
在免疫功能低下或重症患者中，发病率和死亡率较高的侵袭性真菌病正在增加。念珠菌、隐球菌、肺孢子菌和曲霉菌是最常见的病原体，其分布因地理位置、患者病情和医院科室而异。西班牙进行的最新多中心念珠菌血症调查显示，白色念珠菌是最常分离出的菌种，其次是近平滑念珠菌、光滑念珠菌、热带念珠菌和克柔念珠菌，这与其他欧洲或美国的研究不同，在那些研究中光滑念珠菌排名第二。曲霉菌属是丝状真菌中引起侵袭性真菌病的主要病原体，其次是镰刀菌属、赛多孢子菌属和接合菌。烟曲霉是侵袭性曲霉病中最常见的病原体（并且已报道有唑类耐药菌株），但在过去几年中，黄曲霉、构巢曲霉和土曲霉的分离频率不断增加，其频率因地理因素、患者基础疾病或先前的抗真菌治疗而异。
