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[墨西哥一家高专科医院侵袭性真菌感染的发生率。21年的经验]

[Frequency of invasive fungal infections in a Mexican High-Specialty Hospital. Experience of 21 years].

作者信息

Méndez-Tovar Luis Javier, Mejía-Mercado Jessica Aline, Manzano-Gayosso Patricia, Hernández-Hernández Francisca, López-Martínez Rubén, Silva-González Israel

机构信息

Laboratorio de Investigación Médica en Dermatología y Micología, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Ciudad de México, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2016 Sep-Oct;54(5):581-7.

Abstract

BACKGROUND

Factors such as cancer, HIV infection, use of corticosteroids and antibiotics, favors the increase in the number of invasive fungal infections (IFI) worldwide.

METHODS

To determine the frequency and epidemiological aspects of IFI at a mexican, a review of the proven cases diagnosed over the past 21 years (1993-2013) in the Laboratory of Medical Mycology was performed.

RESULTS

A total of 472 cases were identified as: 261 candidiasis, 82 mucormycosis, 60 cryptococcosis, 43 aspergillosis and 16 histoplasmosis. A decrease in the frequency of candidiasis was observed, with 74 cases in the first 6 years and 48 in the last five. C. albicans was the most common agent and pulmonary infection the most prevalent. Cryptococcosis also declined from 24 to 10 cases, mainly caused by C. neoformans; two cases of C. laurentii and C. terreus and C unigutulatus were isolated once. Mucormycosis remained steady, but aspergillosis increased significantly, and from 2 cases found in the first studied period, it rose to 23 in the last one.

CONCLUSIONS

It is important that High Specialty Hospitals have well-equipped laboratories of Medical Mycology. We suggest the creation of a National Reference Center for Mycoses to collect all the data of these infections, in order to help to the development of strategies for health education, prevention, diagnosis and treatment of them.

摘要

背景

癌症、艾滋病毒感染、使用皮质类固醇和抗生素等因素促使全球侵袭性真菌感染(IFI)病例数增加。

方法

为确定墨西哥IFI的发病频率和流行病学特征,对医学真菌学实验室过去21年(1993 - 2013年)诊断的确诊病例进行了回顾。

结果

共鉴定出472例病例,其中念珠菌病261例、毛霉病82例、隐球菌病60例、曲霉病43例、组织胞浆菌病16例。观察到念珠菌病发病率下降,前6年有74例,后5年有48例。白色念珠菌是最常见的病原体,肺部感染最为普遍。隐球菌病也从24例降至10例,主要由新型隐球菌引起;仅分离出2例罗伦隐球菌、土曲霉和单孢隐球菌。毛霉病保持稳定,但曲霉病显著增加,从研究初期发现的2例增至最后一期的23例。

结论

高等专科医院拥有设备完善的医学真菌学实验室很重要。我们建议设立一个国家真菌病参考中心,收集这些感染的所有数据,以帮助制定健康教育、预防、诊断和治疗策略。

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