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如何治疗重症监护病房患者的真菌感染。

How to treat fungal infections in ICU patients.

作者信息

Matthaiou Dimitrios K, Christodoulopoulou Theodora, Dimopoulos George

机构信息

Department of Critical Care, University Hospital ATTIKON, Medical School, University of Athens, 1 Rimini str, Haidari-Athens, 12462, Greece.

出版信息

BMC Infect Dis. 2015 May 2;15:205. doi: 10.1186/s12879-015-0934-8.

Abstract

Fungal infections represent a major burden in the critical care setting with increasing morbidity and mortality. Candidiasis is the leading cause of such infections, with C. albicans being the most common causative agent, followed by Aspergillosis and Mucormycosis. The diagnosis of such infections is cumbersome requiring increased clinical vigilance and extensive laboratory testing, including radiology, cultures, biopsies and other indirect methods. However, it is not uncommon for definitive evidence to be unavailable. Risk and host factors indicating the probability of infections may greatly help in the diagnostic approach. Timely and adequate intervention is important for their successful treatment. The available therapeutic armamentarium, although not very extensive, is effective with low resistance rates for the newer antifungal agents. However, timely and prudent use is necessary to maximize favorable outcomes.

摘要

真菌感染在重症监护环境中是一个主要负担,发病率和死亡率不断上升。念珠菌病是此类感染的主要原因,白色念珠菌是最常见的病原体,其次是曲霉病和毛霉病。此类感染的诊断很麻烦,需要提高临床警惕性并进行广泛的实验室检测,包括放射学检查、培养、活检和其他间接方法。然而,缺乏确凿证据的情况并不少见。表明感染可能性的风险和宿主因素在诊断方法中可能会有很大帮助。及时和充分的干预对其成功治疗很重要。现有的治疗手段虽然不太广泛,但对新型抗真菌药物有效,耐药率较低。然而,为了使治疗效果最大化,必须及时且谨慎地使用这些药物。

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