Wenzel R P
Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City 52242, USA.
Clin Infect Dis. 1995 Jun;20(6):1531-4. doi: 10.1093/clinids/20.6.1531.
Over the past decade, the incidence of hospital-acquired bloodstream infections caused by Candida species has risen and the species associated with such infections have changed. The incidence of candidemia is dramatically higher in high-risk, critical-care units than in other parts of the hospital. Certain underlying physical conditions including acute leukemia, leukopenia, burns, gastrointestinal disease, and premature birth predispose patients to nosocomial candidemia. Independent risk factors include prior treatment with multiple antibiotics, prior Hickman catheterization, isolation of Candida species from sites other than the blood, and prior hemodialysis. In this article some of the challenges posed by the management of nosocomial candidemia are presented in three case studies. In addition, the results of several investigations of nosocomial candidemia at the University of Iowa Hospitals and Clinics are reviewed.
在过去十年中，念珠菌属引起的医院获得性血流感染的发生率有所上升，且与此类感染相关的菌种也发生了变化。高危重症监护病房的念珠菌血症发生率显著高于医院的其他科室。某些基础身体状况，包括急性白血病、白细胞减少症、烧伤、胃肠道疾病和早产，使患者易患医院获得性念珠菌血症。独立危险因素包括先前使用多种抗生素治疗、先前进行希克曼导管插入术、从血液以外部位分离出念珠菌属以及先前进行血液透析。本文通过三个案例研究介绍了医院获得性念珠菌血症管理所带来的一些挑战。此外，还回顾了爱荷华大学医院及诊所对医院获得性念珠菌血症的几项调查结果。
