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恶性肿瘤患儿的念珠菌血症:希腊儿科血液学-肿瘤学会感染工作组的报告

Candidemia in Children with Malignancies: Report from the Infection Working Group of the Hellenic Society of Pediatric Hematology-Oncology.

作者信息

Vasileiou Eleni, Paisiou Anna, Tsipou Charoula, Pourtsidis Apostolos, Galani Vasiliki, Katzilakis Nikolaos, Antoniadi Kondilia, Papakonstantinou Eugenia, Ioannidou Elda, Stiakaki Efthichia, Baka Margarita, Kattamis Antonios, Kitra Vasiliki, Tragiannidis Athanasios

机构信息

Hematology-Oncology Unit, 2nd Department of Pediatrics, Aristotle University of Thessaloniki, AHEPA Hospital, 546 36 Thessaloniki, Greece.

Stem Cell Transplant Unit, Aghia Sophia Children's Hospital, 115 27 Athens, Greece.

出版信息

J Fungi (Basel). 2020 Nov 10;6(4):276. doi: 10.3390/jof6040276.

Abstract

Candidemia is an important cause of morbidity and mortality especially in immunocompromised and hospitalized patients. We retrospectively collected data of candidemia cases that occurred in the seven Hematology-Oncology Departments/Units of Greece and the Stem Cell Transplant Unit between 2015 and 2019. In total, 19 episodes of candidemia in 19 patients were recorded. The majority of the patients (78.9%) had at least one risk factor for candidemia. The most frequent risk factors associated with candidemia observed in our patients were prolonged duration of hospitalization (30 days, range 1-141), presence of a central venous catheter at diagnosis of candidemia (73.7%) and antibiotics use during the last two weeks (84.2%). was the most common species isolated accounting for 42.1%, followed by (26.3%) and (15.8%). Nearly all of the patients (84.2%) received antifungal monotherapy with liposomal amphotericin B or echinocandins. The central venous catheter was removed in 78.6% of patients and the median time between the first positive blood culture and catheter removal was 3 days (range 1-9). Mortality at 28 days was 26.3%. In conclusion, a predominance of non-albicans species was observed in our study in conformity with the global trend.

摘要

念珠菌血症是发病和死亡的重要原因,尤其在免疫功能低下和住院患者中。我们回顾性收集了2015年至2019年间希腊七个血液肿瘤科室/单位以及干细胞移植单位发生的念珠菌血症病例数据。总共记录了19例患者的19次念珠菌血症发作。大多数患者(78.9%)至少有一个念珠菌血症的危险因素。在我们的患者中观察到与念珠菌血症相关的最常见危险因素是住院时间延长(≥30天,范围1 - 141天)、念珠菌血症诊断时存在中心静脉导管(73.7%)以及过去两周内使用抗生素(84.2%)。白色念珠菌是最常见的分离菌种,占42.1%,其次是热带念珠菌(26.3%)和光滑念珠菌(15.8%)。几乎所有患者(84.2%)接受了脂质体两性霉素B或棘白菌素类的抗真菌单药治疗。78.6%的患者拔除了中心静脉导管,首次血培养阳性与导管拔除之间的中位时间为3天(范围1 - 9天)。28天死亡率为26.3%。总之,在我们的研究中观察到非白色念珠菌菌种占优势,这与全球趋势一致。

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