Ture Zeynep, Alp Emine
a Department of Infectious Diseases and Clinical Microbiology , Health Ministry University of Kayseri Education and Research Hospital , Kayseri , Turkey.
b Department of Infectious Diseases and Clinical Microbiology, Infection Control Committee, Faculty of Medicine , Erciyes University , Kayseri , Turkey.
Hosp Pract (1995). 2018 Dec;46(5):253-257. doi: 10.1080/21548331.2018.1510282. Epub 2018 Sep 5.
Invasive candida infections are the most important causes of nosocomial infections in intensive care units and in risky groups such as immunosuppressed patients. These infections lead to undesirable consequences such as increased morbidity and mortality in patients, prolongation of hospital stay, and increased hospital costs. In recent years, the incidence of non-albicans Candida spp.'s has increased. Unfortunately, some of these species are naturally resistant to first-line antifungals. In addition, biofilm formation on the central venous catheter and invasive devices may cause treatment failure. The age of the patients, co-morbid diseases, the units where they are treated, the antibiotics and antifungals that are used for the treatment, and invasive devices are risk factors for invasive candida infections. Some of these risk factors can be reduced by the behavior of health-care workers. The most important goal is to take precautions before the occurrence of invasive candida infections. Infection control measures to prevent hospital transmission of candida are very important. Compliance with hand hygiene before and after contact with the patient is the most important step to prevent the spreading of Candida spp. Observation of maximal barrier precautions during invasive catheterization is another important clause of this aim. Avoiding unnecessary invasive devices, antibiotics, and parenteral nutrition are also important to reduce the colonization of candida.
侵袭性念珠菌感染是重症监护病房以及免疫抑制患者等高危人群医院感染的最重要原因。这些感染会导致不良后果,如患者发病率和死亡率增加、住院时间延长以及医院成本增加。近年来,非白色念珠菌的发病率有所上升。不幸的是,其中一些菌种对一线抗真菌药物天然耐药。此外,中心静脉导管和侵入性装置上形成生物膜可能导致治疗失败。患者的年龄、合并疾病、治疗所在科室、用于治疗的抗生素和抗真菌药物以及侵入性装置都是侵袭性念珠菌感染的危险因素。其中一些危险因素可以通过医护人员的行为来降低。最重要的目标是在侵袭性念珠菌感染发生之前采取预防措施。预防念珠菌在医院传播的感染控制措施非常重要。接触患者前后遵守手部卫生是预防念珠菌传播的最重要步骤。在进行侵入性导管插入术时遵守最大屏障预防措施是该目标的另一个重要条款。避免不必要的侵入性装置、抗生素和肠外营养对于减少念珠菌定植也很重要。