Sandford G R, Merz W G, Wingard J R, Charache P, Saral R
J Infect Dis. 1980 Oct;142(4):503-9. doi: 10.1093/infdis/142.4.503.
Fungal surveillance cultures consisting of urine, stool, and respiratory specimens were analyzed from 37 recipients of bone-marrow transplants and 52 patients undergoing chemotherapy for acute leukemia and other hematologic malignancies. All patients had prolonged aplasia. Sixty-seven percent of the patients were colonized by Candida albicans, and 28% were colonized by Candida tropicalis. No patient was colonized with any species of Aspergillus. There were 21 proven systemic fungal infections: three due to C. albicans, 16 due to C. tropicalis, and two due to Aspergillus. Positive surveillance data for C. tropicalis correlate with disease. Multiple positive-culture data yielded high predictive values (67%-83%), and single positive-culture data yielded slightly lower values as a function of body site. Positive surveillance data for C. albicans did not correlate with disease; negative culture data correlate with the absence of systemic disease due to C. tropicalis and C. albicans. Thus, surveillance data for specific fungal species can aid in diagnosis and appropriate therapy.
对37例骨髓移植受者以及52例因急性白血病和其他血液系统恶性肿瘤接受化疗的患者的尿液、粪便和呼吸道标本进行真菌监测培养分析。所有患者均有长期再生障碍。67%的患者被白色念珠菌定植，28%的患者被热带念珠菌定植。没有患者被任何曲霉菌种定植。有21例确诊的系统性真菌感染：3例由白色念珠菌引起，16例由热带念珠菌引起，2例由曲霉菌引起。热带念珠菌的阳性监测数据与疾病相关。多次阳性培养数据产生较高的预测值（67%-83%），单次阳性培养数据根据身体部位的不同产生略低的值。白色念珠菌的阳性监测数据与疾病无关；阴性培养数据与不存在由热带念珠菌和白色念珠菌引起的系统性疾病相关。因此，特定真菌种类的监测数据有助于诊断和适当治疗。
