Suppr超能文献

喀麦隆雅温得地区感染艾滋病毒患者的隐球菌性脑膜炎:诊断、发病率及新型隐球菌分离株对氟康唑的药敏研究

Cryptoccocal meningitis in Yaoundé (Cameroon) HIV infected patients: Diagnosis, frequency and Cryptococcus neoformans isolates susceptibility study to fluconazole.

作者信息

Kammalac Ngouana T, Dongtsa J, Kouanfack C, Tonfack C, Fomena S, Mallié M, Delaporte E, Boyom F-Fekam, Bertout S

机构信息

Clinical Biology Laboratory, Yaoundé Central Hospital, Cameroon; UMI 233 UM1-IRD-UCAD-UY1 « TransVIHMI » laboratoire de parasitologie et mycologie médicale UFR pharmacie, université de Montpellier 1, 34093 Montpellier, France; Antimicrobial Agents Unit (AMAU), Laboratory for Phytobiochemistry and Medicinal Plants Study, Department of Biochemistry, Faculty of Science, University of Yaoundé I, Cameroon.

Clinical Biology Laboratory, Yaoundé Central Hospital, Cameroon.

出版信息

J Mycol Med. 2015 Mar;25(1):11-6. doi: 10.1016/j.mycmed.2014.10.016. Epub 2014 Nov 21.

Abstract

Cryptococcal meningitis is a mycosis encountered especially in patients with Acquired Immunodeficiency Syndrome and is fatal in the absence of treatment. Information on epidemiology, diagnosis and susceptibility profile to antifungal drugs, are scarce in Cameroon. Authors evaluated the diagnosis possibilities of the cryptococcal meningitis in Cameroon, and studied the antifungal susceptibility of isolated strains to fluconazole, used as first line treatment of the disease in Cameroon. Between December 2009 and July 2011, 146 cerebrospinal fluids obtained from HIV patients with suspicion of meningitis were analysed. The diagnosis procedure involved macroscopic and cyto-chemical analysis, India ink test, culture on Sabouraud chloramphenicol medium and antigen latex agglutination test. Antifungal susceptibility testing of isolated strains to fluconazole was done by the E-test(®) method. The diagnosis of cryptococcal meningitis gave 28.08% positive cases. Among these patients, 80% were at stages III and IV and 20% at stage I of the HIV infection, according to the WHO previous classification. Cyto-chemical analysis showed current findings in the case of cryptococcal meningitis. India ink test and latex agglutination test exhibited very high sensitivity and specificity (>94%). Fluconazole antifungal susceptibility testing gave MICs lower than 32μg/mL to 92.7% of isolated strains and MICs greater than this value to 7.3% of isolates. These results showed that cryptococcal meningitis remains a real problem among HIV infected patients in Yaoundé. The emergence of fluconazole reduced susceptibility strains is worrying. Nevertheless, efficacy of rapid detection tests is interesting because this will help in rapid diagnosis and treatment of patients.

摘要

隐球菌性脑膜炎是一种尤其在获得性免疫缺陷综合征患者中出现的真菌病,若不治疗则会致命。在喀麦隆,关于其流行病学、诊断以及对抗真菌药物的敏感性概况的信息稀缺。作者评估了喀麦隆隐球菌性脑膜炎的诊断可能性,并研究了分离菌株对氟康唑的抗真菌敏感性,氟康唑是喀麦隆用于该病一线治疗的药物。在2009年12月至2011年7月期间,对146份来自疑似脑膜炎的HIV患者的脑脊液进行了分析。诊断程序包括宏观和细胞化学分析、墨汁负染试验、在沙氏氯霉素培养基上培养以及抗原乳胶凝集试验。分离菌株对氟康唑的抗真菌药敏试验采用E-test(®)方法进行。隐球菌性脑膜炎的诊断阳性率为28.08%。根据世界卫生组织之前的分类,在这些患者中,80%处于HIV感染的III期和IV期,20%处于I期。细胞化学分析显示了隐球菌性脑膜炎的当前发现。墨汁负染试验和乳胶凝集试验表现出非常高的敏感性和特异性(>94%)。氟康唑抗真菌药敏试验显示,92.7%的分离菌株的最低抑菌浓度低于32μg/mL,7.3%的分离株的最低抑菌浓度高于此值。这些结果表明,隐球菌性脑膜炎在雅温得的HIV感染患者中仍然是一个实际问题。氟康唑敏感性降低菌株的出现令人担忧。然而,快速检测试验的有效性令人关注,因为这将有助于对患者进行快速诊断和治疗。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验