Kataoka S, Kashiwa M, Saku K, Handa N, Akiyama H
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital, Japan.
Kansenshogaku Zasshi. 1995 Sep;69(9):969-74. doi: 10.11150/kansenshogakuzasshi1970.69.969.
Positive blood cultures reported between 1986 and 1993 at the Tokyo Metropolitan Komagome Hospital were evaluated and all patients with an intravenous hyperalimentation catheter who developed candidemia, a total of 94 patients, were analyzed further, while patients with neutropenia were excluded. The primary diagnosis was malignancy in 87.2% of the cases, and Candida albicans and C. parapsilosis were the main organisms detected. A total of 17 patients died from candidemia. The patients who were positive for C. parapsilosis, however, all survived in spite of the fact that their main treatment was only removal of the catheter (20/32 cases), while eight of 25 patients who developed fungemia due to C. albicans died from the fungemia (p = 0.001). There were no significant differences in their risk factors. Because of the better outcome for the patients who developed candidemia due to C. parapsilosis, we might be able to consider less aggressive treatment for such patients.
对东京都驹込医院1986年至1993年间报告的阳性血培养结果进行了评估，并对所有发生念珠菌血症的接受静脉高营养导管治疗的患者（共94例）进行了进一步分析，同时排除了中性粒细胞减少的患者。87.2%的病例主要诊断为恶性肿瘤，检测到的主要病原体为白色念珠菌和近平滑念珠菌。共有17例患者死于念珠菌血症。然而，近平滑念珠菌检测呈阳性的患者尽管主要治疗仅为拔除导管（20/32例），但全部存活，而25例因白色念珠菌发生真菌血症的患者中有8例死于真菌血症（p = 0.001）。它们的危险因素没有显著差异。由于近平滑念珠菌所致念珠菌血症患者的预后较好，我们或许可以考虑对这类患者采取不太积极的治疗。
