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一名早产新生儿持续性光滑念珠菌血流感染经两性霉素B和卡泊芬净联合治疗成功治愈。

Persistent Candida conglobata bloodstream infection in a preterm neonate successfully treated by combination therapy with amphotericin B and caspofungin.

作者信息

Al-Sweih N, Ahmad S, Khan S, Khan Z, Joseph L, Vayalil S, Chandy R

机构信息

Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait; Microbiology Unit, Maternity Hospital, Safat, Kuwait.

Department of Microbiology, Faculty of Medicine, Kuwait University, Safat, Kuwait.

出版信息

J Mycol Med. 2017 Jun;27(2):271-276. doi: 10.1016/j.mycmed.2017.01.010. Epub 2017 Feb 9.

Abstract

Fungemia due to uncommon/rare Candida species is an emerging problem of global clinical significance. Here, we describe a case of Candida conglobata bloodstream infection in a preterm neonate. The diagnosis was established by repeated isolation of C. conglobata in blood cultures and by detection of rDNA of the fungus in serum samples. The identity of the isolate as C. conglobata was confirmed by sequencing of ITS region and D1/D2 domains of rDNA. Despite initial treatment with a liposomal amphotericin B (AmBisome) for 7 days, the blood culture remained positive. The neonate was successfully treated by combination therapy with caspofungin for 25 days. To the best of our knowledge, this is the first proven report unequivocally proving the etiologic role of C. conglobata in bloodstream infection.

摘要

由不常见/罕见念珠菌属引起的真菌血症是一个具有全球临床意义的新出现问题。在此,我们描述一例早产新生儿发生的球形念珠菌血流感染病例。通过在血培养中反复分离出球形念珠菌以及在血清样本中检测到该真菌的rDNA来确立诊断。通过对rDNA的ITS区域和D1/D2结构域进行测序,证实分离株为球形念珠菌。尽管最初用脂质体两性霉素B(安必素)治疗7天,但血培养仍为阳性。该新生儿通过联合应用卡泊芬净治疗25天获得成功治愈。据我们所知,这是第一份明确证实球形念珠菌在血流感染中病因学作用的经证实报告。

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