Mess T, Daar E S
Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA.
Clin Infect Dis. 1997 Dec;25(6):1350-3. doi: 10.1086/516140.
This study was designed to define the clinical utility of fungal blood cultures for human immunodeficiency virus type 1-infected individuals. A retrospective chart review was performed for all patients admitted to an inpatient AIDS unit who had evidence of an invasive fungal infection. During a 25-month period, 1,162 fungal blood cultures were performed for 322 patients. These cultures, along with bacterial blood cultures, resulted in the isolation of fungi from 26 patients; 15 of these isolates were considered true pathogens. Routine blood cultures were positive for the fungal isolates in all 15 cases: Candida species and Candida glabrata (6 cases), Cryptococcus neoformans (7), Coccidioides immitis (1), and Histoplasma capsulatum (1). All invasive fungal infections were diagnosed by other means before fungal blood cultures were reported as positive. The results of this study suggest that the routine performance of such cultures in clinical practice should be reevaluated.
本研究旨在确定真菌血培养对人类免疫缺陷病毒1型感染个体的临床实用性。对入住艾滋病住院病房且有侵袭性真菌感染证据的所有患者进行了回顾性病历审查。在25个月期间,对322例患者进行了1162次真菌血培养。这些培养物以及细菌血培养物,从26例患者中分离出真菌;其中15株分离菌被认为是真正的病原体。在所有15例病例中,常规血培养对真菌分离菌呈阳性:念珠菌属和光滑念珠菌(6例)、新型隐球菌(7例)、粗球孢子菌(1例)和荚膜组织胞浆菌(1例)。在真菌血培养报告为阳性之前,所有侵袭性真菌感染均通过其他方法诊断。本研究结果表明,临床实践中此类培养的常规操作应重新评估。