Hoppe J E, Klingebiel T, Niethammer D
University Children's Hospital, Tübingen, Germany.
Mycoses. 1995 Jan-Feb;38(1-2):51-7. doi: 10.1111/j.1439-0507.1995.tb00008.x.
We quantitatively studied the orointestinal yeast colonization of 15 consecutive paediatric patients who underwent 16 bone marrow transplantations (BMT). Cultures were performed initially, longitudinally weekly during the period of aplasia (in-patient treatment) and, if possible, also during out-patient follow-up. With one exception, all patients received fluconazole as antifungal prophylaxis. Patients remained free of yeasts during the complete observation period only in six out of 16 cases (38%). Non-albicans species of Candida were isolated in six out of 16 cases (38%), mainly C. glabrata (five out of 16; 31%). All of these patients had undergone allogeneic BMT. In one case, there was indirect evidence of systemic invasion by C. glabrata. Even combined prophylaxis with fluconazole and and amphotericin B suspension could not reliably prevent yeast colonization but this combination at present appears to be the optimal regime. Regular concomitant Candida serology (determination of specific antibodies by three methods) proved to be a valuable additional surveillance method.
我们对连续15例接受了16次骨髓移植（BMT）的儿科患者的口腔肠道酵母菌定植情况进行了定量研究。最初进行了培养，在再生障碍期（住院治疗期间）每周纵向进行一次培养，如有可能，在门诊随访期间也进行培养。除1例外，所有患者均接受氟康唑作为抗真菌预防用药。在16例病例中，仅6例（38%）患者在整个观察期内未出现酵母菌感染。16例中有6例（38%）分离出非白色念珠菌，主要是光滑念珠菌（16例中有5例；31%）。所有这些患者均接受了异基因BMT。在1例病例中，有光滑念珠菌全身侵袭的间接证据。即使联合使用氟康唑和两性霉素B悬液进行预防，也不能可靠地预防酵母菌定植，但目前这种联合用药似乎是最佳方案。定期同时进行念珠菌血清学检查（通过三种方法测定特异性抗体）被证明是一种有价值的额外监测方法。
