Wilson Aze, Delport Johan, Ponich Terry
Division of Clinical Pharmacology and Division of Gastroenterology, Department of Medicine, London Health Sciences Centre, Western University, University Campus, 339 Windermere Road, Room C9-101, London, ON, Canada N6A 5W9.
Department of Medical Microbiology, London Health Sciences Centre, Western University, Victoria Campus, 800 Commissioners Road E., Room B10-105, London, ON, Canada N6A 5W9.
Int J Microbiol. 2014;2014:371631. doi: 10.1155/2014/371631. Epub 2014 Dec 3.
Background. Candida glabrata (C. glabrata) has become a recognized pathogen in fungal esophagitis. A proportion of these isolates are azole-resistant which may have treatment implications. Variability in the prevalence of this organism exists in the limited data available. Objective. To determine the incidence of C. glabrata esophagitis in a North American hospital setting and to highlight factors that may predispose patients to this condition. Methods. Patient charts were collected from January 1, 2009 to July 30, 2011. Any charts of patients identified as having esophagitis with a positive fungal culture were reviewed for the species of Candida and the presence of factors that would predispose them to esophageal candidiasis. Results. The prevalence of Candida esophagitis based on culture was 2.2% (37 subjects). C. glabrata was the 2nd most prevalent pathogen identified (24.3% or 9 subjects). Of the C. glabrata cohort, all patients had at least one factor predisposing them to candidiasis. Conclusion. C. glabrata esophagitis makes up a large portion of the candidal esophagitis seen in hospital. C. glabrata infections were associated with at least one risk factor for candidal infection. Given its resistance to azole-based therapy, this may have treatment implications for how candidal esophagitis is approached by the clinician.
背景。光滑念珠菌已成为真菌性食管炎中一种公认的病原体。这些分离株中有一部分对唑类耐药，这可能会对治疗产生影响。现有有限数据显示该病原体的患病率存在差异。目的。确定北美医院环境中光滑念珠菌食管炎的发病率，并强调可能使患者易患此病的因素。方法。收集2009年1月1日至2011年7月30日期间的患者病历。对任何被确定为患有食管炎且真菌培养呈阳性的患者病历进行审查，以确定念珠菌的种类以及是否存在使他们易患食管念珠菌病的因素。结果。基于培养的念珠菌食管炎患病率为2.2%（37名受试者）。光滑念珠菌是第二常见的病原体（24.3%或9名受试者）。在光滑念珠菌组中，所有患者至少有一个使他们易患念珠菌病的因素。结论。光滑念珠菌食管炎在医院所见的念珠菌性食管炎中占很大比例。光滑念珠菌感染与至少一种念珠菌感染的危险因素相关。鉴于其对唑类治疗的耐药性，这可能会对临床医生治疗念珠菌性食管炎的方式产生治疗影响。
