Dyess D L, Garrison R N, Fry D E
Arch Surg. 1985 Mar;120(3):345-8. doi: 10.1001/archsurg.1985.01390270083014.
Eighty-three patients with 117 episodes of candidemia were reviewed to examine the clinically significant variables and the results of treatment for this problem. Mortality was 52%. Patients who had bacteremia either synchronously or metachronously in association with Candida species had poorer survival rates. Staphylococcal and enterococcal species were the most frequently associated bacteria. Patients with Candida parapsilosis had better survival rates than patients with other species. Portals of entry for fungemia were catheters, wounds, the urinary tract, and the peritoneal cavity, but were undefined in 54% of patients. Antifungal chemotherapy could not be identified as affecting the outcome in these patients. It is suggested that candidemia in most patients represents a failure of host defense, and that septicemia of either bacteria or fungi may arise from the gastrointestinal tract in critically ill, immunocompromised patients.
对83例发生117次念珠菌血症的患者进行了回顾，以检查具有临床意义的变量以及针对该问题的治疗结果。死亡率为52%。同时或异时发生念珠菌属菌血症的患者生存率较低。葡萄球菌和肠球菌是最常伴发的细菌。近平滑念珠菌感染患者的生存率高于其他菌种感染患者。真菌血症的感染途径为导管、伤口、泌尿道和腹腔，但54%的患者感染途径不明。无法确定抗真菌化疗对这些患者的预后有影响。提示大多数患者的念珠菌血症代表宿主防御功能失败，重症免疫功能低下患者的细菌或真菌败血症可能源于胃肠道。
