Alvarez M, Lopez Ponga B, Rayon C, Garcia Gala J, Roson Porto M C, Gonzalez M, Martinez-Suarez J V, Rodriguez-Tudela J L
Servico de Microbiologia, Hospital Central de Asturias, Oviedo, Spain.
J Clin Microbiol. 1995 Dec;33(12):3290-5. doi: 10.1128/jcm.33.12.3290-3295.1995.
Four cases of fatal disseminated Scedosporium prolificans (inflatum) infection occurring in neutropenic patients are reported. Because of hospital renovation, the patients were cared for in a temporary hematologic facility. S. prolificans (inflatum) was isolated from blood cultures of these four patients, two of whom underwent full necropsy, and revealed abundant vegetative hyphae and ovoid conida with truncate bases in many organs. In vitro susceptibility testing of fungal strains showed all isolates to be resistant to amphotericin B, flucytosine, miconazole, ketoconazole, fluconazole, and itraconazole, with MICs greater than 16 micrograms/ml. The reported infections, two in each of two rooms, occurred over a period of 1 month, with very similar clinical outcomes. Circumstancial evidence suggested a nosocomial outbreak, but the environmental samples collected from the rooms, corridors, and adjacent areas did not yield S. prolificans (inflatum). Nevertheless, circumstantial evidence suggested a nosocomial outbreak of S. prolificans (inflatum) infection.
报告了4例发生在中性粒细胞减少患者中的播散性多育赛多孢菌（膨胀赛多孢菌）致死性感染病例。由于医院翻新，这些患者在临时血液科设施中接受治疗。从这4例患者的血培养物中分离出了多育赛多孢菌（膨胀赛多孢菌），其中2例患者进行了完整尸检，结果显示在许多器官中均有大量的营养菌丝和基部截形的卵形分生孢子。对真菌菌株进行的体外药敏试验表明，所有分离株对两性霉素B、氟胞嘧啶、咪康唑、酮康唑、氟康唑和伊曲康唑均耐药，最低抑菌浓度大于16微克/毫升。所报告的感染发生在两个房间，每个房间各有2例，历时1个月，临床结局非常相似。间接证据提示存在医院感染暴发，但从病房、走廊及相邻区域采集的环境样本未分离出多育赛多孢菌（膨胀赛多孢菌）。尽管如此，间接证据仍提示发生了多育赛多孢菌（膨胀赛多孢菌）感染的医院感染暴发。
