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[重症监护患者真菌感染的实验室诊断可能性]

[Laboratory diagnostic possibilities in fungus infections in intensive care patients].

作者信息

Marklein G, Weil H P, Rommelsheim K

机构信息

Institut für Medizinische Mikrobiologie und Immunologie, Universität Bonn.

出版信息

Anasth Intensivther Notfallmed. 1989 Jun;24(3):172-6.

PMID:2764266
Abstract

Severe yeast infections of intensive care patients are promoted by numerous predisposing factors among which antibacterial broad spectrum therapy plays an important role. Since typical clinical pictures are lacking, basic procedures of mycological diagnostics are culture and differentiation of yeast strains and detection of immunological reactions against yeast antigens as well. Among 200 intensive-care patients with suspected systemic mycosis, Candida albicans was the prevailing yeast, followed by Torulopsis glabrata and Candida krusei. In the immunocompetent patient, serological procedures discriminating between antibodies of the IgG and IgM class may be suitable for the surveillance of the course of the disease. - In early stages of endomycotic infections and in the immunocompromised host as well, detection of candida antigens by means of specific latex tests and the detection of yeast-specific metabolites (e.g. arabinitol) by gas chromatographic methods provide helpful tools in the diagnosis of severe opportunistic fungal infections.

摘要

重症监护患者的严重酵母菌感染由多种易感因素促成,其中广谱抗菌治疗起着重要作用。由于缺乏典型的临床表现,真菌学诊断的基本程序是酵母菌菌株的培养与鉴别以及针对酵母抗原的免疫反应检测。在200例疑似全身性真菌病的重症监护患者中,白色念珠菌是最常见的酵母菌,其次是光滑假丝酵母菌和克柔念珠菌。对于免疫功能正常的患者,区分IgG和IgM类抗体的血清学程序可能适用于疾病进程的监测。——在内生性真菌感染的早期阶段以及免疫功能低下的宿主中,通过特异性乳胶试验检测念珠菌抗原以及通过气相色谱法检测酵母特异性代谢产物(如阿拉伯糖醇),为严重机会性真菌感染的诊断提供了有用的工具。

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