Pemán Javier, Zaragoza Rafael, Salavert Miguel
Miguel Salavert Lletí. Unidad de Enfermedades Infecciosas; Hospital Universitario y Politécnico La Fe, Boulevar sur s/n; 46026; Valencia, Spain.
Rev Esp Quimioter. 2013 Dec;26(4):298-311.
Knowledge of the epidemiology of invasive fungal diseases caused by yeasts (Candida spp., especially) in health care settings allows the establishment of the levels necessary for its prevention. A first step is to identify groups of patients at high risk of nosocomial invasive fungal infections, establish accurate risk factors, observing the periods of greatest risk, and analyze the epidemiological profile in genera and species as well as the patterns of antifungal resistance. Secondly, mechanisms to avoid persistent exposure to potential fungal pathogens must be programed, protecting areas and recommending measures such as the control of the quality of the air and water, inside and outside the hospital, and other products or substances able to cause outbreaks. Finally, apart from the correct implementation of these measures, in selected patients at very high risk, the use of antifungal prophylaxis should be considered following the guidelines published.
了解医疗机构中由酵母(尤其是念珠菌属)引起的侵袭性真菌病的流行病学情况,有助于确定预防所需的水平。第一步是识别医院获得性侵袭性真菌感染的高危患者群体,确定准确的危险因素,观察最高风险期,并分析属和种的流行病学特征以及抗真菌耐药模式。其次,必须规划避免持续接触潜在真菌病原体的机制,保护区域,并推荐诸如控制医院内外空气和水以及其他可能导致暴发的产品或物质的质量等措施。最后,除了正确实施这些措施外,对于选定的极高危患者,应按照已发布的指南考虑使用抗真菌预防药物。