Instituto de Infectologia Emílio Ribas, São Paulo, SP, Brazil.
Mycopathologia. 2014 Aug;178(1-2):71-8. doi: 10.1007/s11046-014-9755-3. Epub 2014 Jun 21.
Invasive fungal infections (IFIs) represent one of the main causes of morbimortality in immunocompromised patients. Pneumocystosis, cryptococcosis and histoplasmosis are the most frequently occurring IFIs in patients with acquired immunodeficiency syndrome (AIDS). Fungi, such as Candida spp. and Aspergillus spp., may cause severe diseases during the course of an HIV infection. Following the introduction of highly active anti-retroviral therapy, there has been a marked reduction of opportunistic fungal infections, which today is 20-25 % of the number of infections observed in the mid-1990s. This study is an observational and retrospective study aimed at the characterising IFI incidence and describing the epidemiology, clinical diagnostic and therapeutic features and denouement in HIV/AIDS patients. In HIV/AIDS patients, the IFI incidence is 54.3/1,000 hospitalisation/year, with a lethality of 37.7 %. Cryptococcosis represents the main opportunistic IFI in the population, followed by histoplasmosis. Nosocomial pathogenic yeast infections are caused principally by Candida spp., with a higher candidemia incidence at our institution compared to other Brazilian centres.
侵袭性真菌感染(IFI)是免疫功能低下患者发病和死亡的主要原因之一。卡氏肺孢子菌肺炎、隐球菌病和组织胞浆菌病是艾滋病(AIDS)患者最常发生的 IFI。在 HIV 感染过程中,念珠菌属和曲霉属等真菌可引起严重疾病。随着高效抗逆转录病毒疗法的引入,机会性真菌感染明显减少,今天的发病率是 20-25%,比 20 世纪 90 年代中期观察到的感染数量减少了一半。本研究是一项观察性和回顾性研究,旨在描述 HIV/AIDS 患者的 IFI 发生率和流行病学、临床诊断和治疗特征及结局。在 HIV/AIDS 患者中,IFI 的发病率为 54.3/1000 人住院/年,死亡率为 37.7%。隐球菌病是该人群中主要的机会性 IFI,其次是组织胞浆菌病。医院获得性酵母感染主要由念珠菌属引起,与巴西其他中心相比,本机构的念珠菌血症发病率更高。