Otcenásek M, Hamácek F
J Hyg Epidemiol Microbiol Immunol. 1981;25(4):465-76.
Modern therapeutic procedures that are based on advanced chemotherapy and modern medical technique have led to a prolongation of chronic patient's survival, but have also created conditions for the development of till now little known infectious complications. Among these are, no doubt, mycotic diseases caused by opportunistic microorganisms. Primarily apathogenic fungi, living as a rule in the external environment as saprophytes or colonizing as harmless epiphytes the integumental localizations of healthy humans, start to behave in the subjects with reduced resistance as invasive pathogens. The authors summarize pertinent information of most important systemic mycotic infections of this nature, which occur on the territory of Czechoslovakia: candidiasis, aspergillosis, phycomycosis, cryptococcosis and nocardiosis. Considering the mycological, ecological and pathophysiological aspects of these infections, the authors try to elucidate not only theoretical principles of the etiological agents' opportunism, but also practical impacts of the sustained increase in the number of these diseases. Apart from data on the extrahuman existence of these microorganisms, the authors provide characteristics of the most important pathogenetic mechanisms facilitating their paratrophic propagation. Since the basic conditions of the onset of complications caused by the opportunistic mycotic agents are in principle complied with in almost every hospitalized patient, emphasis is put particularly on factors leading to iatrogenic lesions. Constant close cooperation between the attending physician and microbiologist is considered as one of the basic preconditions for a successful therapeutical control of these pathological conditions.
基于先进化疗和现代医学技术的现代治疗方法延长了慢性病患者的生存期,但也为迄今鲜为人知的感染性并发症的发生创造了条件。其中,无疑包括由机会性微生物引起的真菌病。主要为非致病性真菌,通常作为腐生菌生活在外部环境中,或作为无害的附生植物定殖于健康人的体表部位,在抵抗力降低的个体中开始表现为侵袭性病原体。作者总结了在捷克斯洛伐克境内发生的这类最重要的全身性真菌感染的相关信息:念珠菌病、曲霉病、毛霉病、隐球菌病和诺卡菌病。考虑到这些感染的真菌学、生态学和病理生理学方面,作者不仅试图阐明病原体机会性的理论原理,还试图阐明这些疾病数量持续增加的实际影响。除了这些微生物在人体外生存的数据外,作者还提供了促进其寄生性繁殖的最重要致病机制的特征。由于几乎每位住院患者原则上都符合机会性真菌病原体引起并发症的基本条件,因此特别强调导致医源性损害的因素。主治医师与微生物学家之间持续密切的合作被认为是成功治疗控制这些病理状况的基本前提之一。