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原位溶菌酶酶疗法对真菌生物膜所致腹膜透析导管梗阻的显著疗效：一例报告

Promising effect of in-situ lyticase enzyme therapy on peritoneal dialysis catheter obstruction from fungal biofilm: A case report.

作者信息

Thongsricome Thana, Kanjanabuch Talerngsak, Maeboonruen Nopparat, Pavatung Preeyarat, Katavetin Pisut, Eiam-Ong Somchai

机构信息

Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Thailand.

Center of Excellence in Kidney Metabolic Disorders, Faculty of Medicine, Chulalongkorn University, Thailand.

出版信息

Med Mycol Case Rep. 2020 Dec;30:26-28. doi: 10.1016/j.mmcr.2020.09.006. Epub 2020 Oct 1.

DOI:10.1016/j.mmcr.2020.09.006
PMID:33020729
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7527791/
Abstract

We reported the first clinical use of lyticase enzyme in salvaging the peritoneal dialysis (PD) catheter obstruction from fungal biofilm during the COVID-19 pandemic era with an impressive result in PD patient presenting with fungal peritonitis and ultrafiltration failure. The organism species was disclosed from PD effluent and catheter cultures. Adjuvant treatment with in-situ lyticase may be considered for catheter salvage therapy if the catheter could not promptly removed in time.

摘要

我们报告了在新冠疫情期间首次临床使用溶菌酶挽救因真菌生物膜导致的腹膜透析（PD）导管阻塞的情况，对于出现真菌性腹膜炎和超滤失败的PD患者取得了令人瞩目的效果。从PD流出液和导管培养物中发现了病原体种类。如果导管不能及时拔除，可考虑采用原位溶菌酶辅助治疗进行导管挽救治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/7559276/f8d8598052c6/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/7559276/dc2846e6e127/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/7559276/f8d8598052c6/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/7559276/dc2846e6e127/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb3/7559276/f8d8598052c6/gr2.jpg

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本文引用的文献

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The efficacy of lyticase and β-glucosidase enzymes on biofilm degradation of Pseudomonas aeruginosa strains with different gene profiles.溶菌酶和β-葡萄糖苷酶对不同基因谱铜绿假单胞菌生物膜降解的效果。
BMC Microbiol. 2019 Dec 12;19(1):291. doi: 10.1186/s12866-019-1662-9.
2
Fungal Biofilms and Polymicrobial Diseases.真菌生物膜与多微生物疾病
J Fungi (Basel). 2017 May 10;3(2):22. doi: 10.3390/jof3020022.
3
Dispersal of single and mixed non-albicans Candida species biofilms by β-1,3-glucanase in vitro.体外β-1,3-葡聚糖酶对单种及混合非白念珠菌生物膜的分散作用。
Microb Pathog. 2017 Dec;113:342-347. doi: 10.1016/j.micpath.2017.10.057. Epub 2017 Nov 1.
4
ISPD Peritonitis Recommendations: 2016 Update on Prevention and Treatment.国际腹膜透析学会腹膜炎推荐意见：2016年预防与治疗更新版
Perit Dial Int. 2016 Sep 10;36(5):481-508. doi: 10.3747/pdi.2016.00078. Epub 2016 Jun 9.
5
Fungal β-1,3-glucan increases ofloxacin tolerance of Escherichia coli in a polymicrobial E. coli/Candida albicans biofilm.真菌β-1,3-葡聚糖可提高大肠杆菌/白色念珠菌混合生物膜中大肠杆菌对氧氟沙星的耐受性。
Antimicrob Agents Chemother. 2015;59(6):3052-8. doi: 10.1128/AAC.04650-14. Epub 2015 Mar 9.
6
Characteristics and outcomes of fungal peritonitis in a modern North American cohort.现代北美队列中真菌性腹膜炎的特征与结局
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Keratitis-associated fungi form biofilms with reduced antifungal drug susceptibility.角膜炎相关真菌形成生物膜，降低了抗真菌药物的敏感性。
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