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中国恶性肿瘤患者口腔念珠菌定植情况及其危险因素

Occurrence of oral Candida colonization and its risk factors among patients with malignancies in China.

作者信息

Sun Haiyan, Chen Yong, Zou Xuan, Li Huan, Yin Xiuyun, Qin Haifeng, Liu Rongrui, Yu Changlin, Li Qihong, Yu Kaitao, Han Xuelin, Zou Jingcai, Ge Cheng, Han Li

机构信息

Department of Stomatology, 307 Hospital, PLA, 8# Dongda Str., 100071, Beijing, China.

Center for Hospital Infection Control, Chinese PLA Institute for Disease Control and Prevention, Academy of Military Medical Sciences, 20# Dongda Str., 100071, Beijing, China.

出版信息

Clin Oral Investig. 2016 Apr;20(3):459-67. doi: 10.1007/s00784-015-1524-2. Epub 2015 Jul 30.

Abstract

OBJECTIVES

Oral colonization of Candida could lead to later development of oropharyngeal candidiasis or candidemia among the immunocompromised patients. This study aims to describe the occurrence and risk factors of oral Candida colonization in patients with malignancies.

MATERIALS AND METHODS

From October 2012 to March 2013, 78 patients with pulmonary cancer (group I), 101 patients with gastrointestinal tract tumor (group II), 79 patients with hematopoietic system malignant tumor (group III), and 101 healthy controls were consecutively recruited in a hospital in Beijing, China. The oral rinse samples were taken and Candida species were identified; the enzymes activities were tested.

RESULTS

In total, 110 and 27 Candida strains were isolated from 91 patients and 26 controls, respectively. The oral colonization rate with Candida albicans in group III (12.7 %) was significant lower than that in group I (30.8 %), group II (33.7 %), and control group (25.7 %). The oral colonization rates with non-albicans Candida species in group I, group II, and group III were 15.4, 10.9, and 12.7 %, respectively, while only one non-albicans Candida strain was identified in control group. The non-albicans Candida species exhibited a lower virulence than C. albicans. Age was an independent risk factor for Candida colonization in patients with pulmonary cancer and digestive tract malignant tumor, "Teeth brush <1 time/day" was an independent risk factor for Candida colonization in patients with hematopoietic system tumor.

CONCLUSIONS

The differences of risk factors for oral Candida colonization in patients with different cancers require different strategies for the prevention and control of Candida infection.

CLINICAL RELEVANCE

Old aged patients with pulmonary cancer and digestive tract malignant tumor are high-risk population for Candida colonization. Increasing frequency of teeth brush might be helpful for preventing Candida colonization.

摘要

目的

念珠菌口腔定植可能导致免疫功能低下患者随后发生口腔念珠菌病或念珠菌血症。本研究旨在描述恶性肿瘤患者口腔念珠菌定植的发生率及危险因素。

材料与方法

2012年10月至2013年3月,在中国北京的一家医院连续招募了78例肺癌患者(I组)、101例胃肠道肿瘤患者(II组)、79例造血系统恶性肿瘤患者(III组)以及101名健康对照者。采集口腔冲洗样本并鉴定念珠菌种类;检测酶活性。

结果

分别从91例患者和26例对照者中分离出110株和27株念珠菌菌株。III组白色念珠菌的口腔定植率(12.7%)显著低于I组(30.8%)、II组(33.7%)和对照组(25.7%)。I组、II组和III组非白色念珠菌的口腔定植率分别为15.4%、10.9%和12.7%,而对照组仅鉴定出1株非白色念珠菌菌株。非白色念珠菌的毒力低于白色念珠菌。年龄是肺癌和消化道恶性肿瘤患者念珠菌定植的独立危险因素,“每天刷牙<1次”是造血系统肿瘤患者念珠菌定植的独立危险因素。

结论

不同癌症患者口腔念珠菌定植的危险因素存在差异,需要采取不同的策略预防和控制念珠菌感染。

临床意义

老年肺癌和消化道恶性肿瘤患者是念珠菌定植的高危人群。增加刷牙频率可能有助于预防念珠菌定植。

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