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癌症患者的真菌尿症:50例患者的危险因素、临床表现及结局分析

Funguria in cancer patients: analysis of risk factors, clinical presentation and outcome in 50 patients.

作者信息

Oravcova E, Lacka J, Drgona L, Studena M, Sevcikova L, Spanik S, Svec J, Kukuckova E, Grey E, Silva J, Krcméry V

机构信息

Dept. of Medicine, University of Trnava, Slovak Republic.

出版信息

Infection. 1996 Jul-Aug;24(4):319-23. doi: 10.1007/BF01743368.

Abstract

Fifty cancer patients with funguria of > 10(5) CFU/ml, dysuria and leukocyturia were retrospectively analyzed for etiology, risk factors and outcome. In 72% of cases Candida albicans and in 28% non-albicans Candida spp. (Candida krusei, Candida tropicalis) and non-Candida spp. yeasts (Blastoschizomyces capitatus) were isolated. Torulopsis glabrata was not found among these patients. The most frequent risk factors were: antibiotic therapy with more than one antibiotic agent (96%), concomitant fungal infection in other localizations than the urinary tract (36%), colonization with the same species (48%), catheterization with urinary catheter or nephrostomy (46%), prophylaxis with quinolones (50%) and previous therapy with corticosteroids (72%). Structural or anatomic malformations of the urinary tract (26%), neutropenia (28%), antifungal prophylaxis with azoles (22%), and diabetes mellitus (12%) were less frequently seen. Thirty of 36 patients treated with systemic antifungals were cured and six were not.

摘要

对50例真菌尿菌量>10(5) CFU/ml、伴有排尿困难和白细胞尿的癌症患者进行回顾性分析,以明确病因、危险因素及预后。72%的病例分离出白色念珠菌,28%分离出非白色念珠菌属(克柔念珠菌、热带念珠菌)及非念珠菌属酵母(头裂芽生菌)。这些患者中未发现光滑念珠菌。最常见的危险因素为:使用一种以上抗生素进行抗生素治疗(96%)、尿路以外其他部位合并真菌感染(36%)、同种菌定植(48%)、留置导尿管或肾造瘘术(46%)、使用喹诺酮类药物进行预防(50%)以及既往使用皮质类固醇治疗(72%)。尿路结构或解剖畸形(26%)、中性粒细胞减少(28%)、使用唑类药物进行抗真菌预防(22%)以及糖尿病(12%)则较少见。36例接受全身抗真菌治疗的患者中,30例治愈,6例未治愈。

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