高危住院血液病患者在使用棘白菌素类药物治疗期间出现突破性侵袭性真菌感染。
Breakthrough invasive fungal diseases during echinocandin treatment in high-risk hospitalized hematologic patients.
机构信息
Department of Medicine, Queen Mary Hospital, Professorial Block, Pokfulam Road, Hong Kong, China.
出版信息
Ann Hematol. 2014 Mar;93(3):493-8. doi: 10.1007/s00277-013-1882-2. Epub 2013 Aug 15.
The frequency of breakthrough invasive fungal diseases (IFDs) during echinocandin therapy is unclear. We retrospectively analyzed 534 hematologic patients treated with echinocandin (caspofungin, N = 55; micafungin, N = 306; anidulafungin, N = 173). Four proven IFDs were found, caused by Candida parapsilosis (N = 2), C. parapsilosis and Candida glabrata (N = 1), and Fusarium species (N = 1). Four cases of possible IFDs were observed, all showing pulmonary infection. One case showed features suggestive of hepatosplenic candidiasis. Six of these eight cases had previously received the purine analog clofarabine. Breakthrough IFD during echinocandin treatment occurred infrequently (1.5 %), caused predominantly by Candida species. Clofarabine usage was an important risk factor.
棘白菌素类药物治疗期间侵袭性真菌病（IFD）突破的频率尚不清楚。我们回顾性分析了 534 例接受棘白菌素治疗的血液病患者（米卡芬净，N=306；卡泊芬净，N=55；阿尼芬净，N=173）。发现 4 例确诊 IFD，由近平滑念珠菌（N=2）、近平滑念珠菌和光滑念珠菌（N=1）和镰刀菌属（N=1）引起。观察到 4 例可能的 IFD，均表现为肺部感染。1 例表现出肝脾念珠菌病的特征。这 8 例中有 6 例之前接受过嘌呤类似物克拉屈滨。棘白菌素类药物治疗期间 IFD 突破的发生率较低（1.5%），主要由念珠菌引起。克拉屈滨的使用是一个重要的危险因素。
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