Rodero L, Boutureira M, Demkura H, Burkett A, Fernández C, Losso M, Jáuregui Rueda H, Monticelli A, Vitale R, Canteros C, Hochenfellner F, Vivot W, Davel G
Departamento Micología, Instituto Nacional de Microbiología Dr. Carlos G. Malbrán, Buenos Aires, Argentina.
Rev Argent Microbiol. 1997 Jan-Mar;29(1):7-15.
Candidiasis has increased its frequency over the last decade, particularly among hospitalized patients where it is accompanied with high rates of mortality, and in patients with AIDS who are predisposed to oropharyngeal or esophageal candidiasis. The aim of this study was to determine the frequency of appearance of different yeast species and the resistance profile to current antifungal drugs in hospitalized pediatric patients and adult HIV patients from 5 institutions of Buenos Aires City and suburbs, and La Plata City, during the period 1993-1995, in order to obtain local and updated information. Candida albicans was the etiologic agent recovered in 87% of the 214 HIV positive patients with oropharyngeal candidosis, and in 50% of the 209 hospitalized pediatric patients. In the latter group 28% of these infections were due to Candida parapsilosis and 18% to Candida tropicalis, but only 2% and 4% of oral candidosis were caused by these organisms. Detection of Malassezia furfur and Hansenula anomala, responsible of systemic infections, and Trichosporon beigelii, isolated from a burn patient, were considered remarkable since these organisms appear to be emerging pathogens. Azole resistant species as Candida krusei and C. glabrata were mostly recovered from HIV positive patients, exposed to fluconazole treatment. A very low number of amfotericin B "resistant" yeasts (n = 9) were observed in both groups. However, resistance to azole drugs, particularly to fluconazole, was found in pediatric patients (13%) and in HIV infected adults (34%).
念珠菌病在过去十年中发病率有所上升,尤其是在住院患者中,其死亡率很高,在艾滋病患者中,易患口咽或食管念珠菌病。本研究的目的是确定1993 - 1995年期间,来自布宜诺斯艾利斯市及郊区和拉普拉塔市5家机构的住院儿科患者和成人HIV患者中不同酵母菌种的出现频率以及对当前抗真菌药物的耐药情况,以便获得当地的最新信息。白色念珠菌是214例患有口咽念珠菌病的HIV阳性患者中87%的病原体,也是209例住院儿科患者中50%的病原体。在后一组中,28%的感染是由近平滑念珠菌引起的,18%是由热带念珠菌引起的,但只有2%和4%的口腔念珠菌病是由这些微生物引起的。检测到负责全身感染的糠秕马拉色菌和异常汉逊酵母,以及从一名烧伤患者中分离出的白吉利丝孢酵母,被认为是值得注意的,因为这些微生物似乎是新兴病原体。耐唑类的克鲁斯念珠菌和光滑念珠菌主要从接受氟康唑治疗的HIV阳性患者中分离出来。两组中观察到的两性霉素B“耐药”酵母数量都非常少(n = 9)。然而,在儿科患者(13%)和HIV感染成人(34%)中发现了对唑类药物,尤其是对氟康唑的耐药性。