真菌血流感染57例临床分析

被引:14
作者
许晓倩 [1 ]
陈莉 [1 ]
吕书晴 [1 ]
沈茜 [2 ]
许育 [2 ]
杨建民 [1 ]
邱慧颖 [1 ]
王健民 [1 ]
机构
[1] 第二军医大学长海医院血液科
[2] 第二军医大学长海医院检验科
关键词
真菌血流感染; 氟康唑; 卡泊芬净; 两性霉素B; 经验性治疗;
D O I
10.16718/j.1009-7708.2009.03.014
中图分类号
R519 [真菌与放线菌传染病];
学科分类号
100201 [内科学];
摘要
目的分析真菌血流感染的临床特征,进一步探讨真菌血流感染的防治措施。方法对2003—2008年医院诊断的真菌血流感染57例进行回顾性临床分析。结果白念珠菌是真菌血流感染的主要病原体,占42.1%;真菌血流感染的发生与广谱抗生素应用、中心静脉置管、恶性肿瘤和使用免疫抑制剂有关;治疗有效率为50.0%,7例患者在未治疗前病情恶化死亡,总病死率为56.1%。预后相关因素分析提示使用过卡泊芬净与两性霉素B治疗明显利于患者生存,而高APACHE评分、未行抗真菌治疗及行全胃肠外营养患者病死率较高。结论广谱抗菌药使用、中心静脉插管与真菌血流感染相关性可能更强;对氟康唑治疗无效的患者应尽早更换为两性霉素B或棘白菌素类。
引用
收藏
页码:228 / 232
页数:5
相关论文
共 5 条
[1]
Micafungin versus liposomal amphotericin B for candidaemia and invasive candidosis: a phase III randomised double-blind trial [J].
Kuse, Ernst-Ruediger ;
Chetchotisakd, Ploenchan ;
da Cunha, Clovis Arns ;
Ruhnke, Markus ;
Barrios, Carlos ;
Raghunadharao, Digumarti ;
Sekhon, Jagdev Singh ;
Freire, Antonio ;
Ramasubramanian, Venkatasubramanian ;
Demeyer, Ignace ;
Nucci, Marcio ;
Leelarasamee, Amorn ;
Jacobs, Frederique ;
Decruyenaere, Johan ;
Pittet, Didier ;
Ullmann, Andrew J. ;
Ostrosky-Zeichner, Luis ;
Lortholary, Olivier ;
Koblinger, Sonja ;
Diekmann-Berndt, Heike ;
Cornely, Oliver A. .
LANCET, 2007, 369 (9572) :1519-1527
[2]
Incidence, risk factors, and predictors of outcome of candidemia. Survey in 2 Italian university hospitals [J].
Bassetti, Matteo ;
Trecarichi, Enrico Maria ;
Righi, Elda ;
Sanguinetti, Maurizio ;
Bisio, Francesca ;
Posteraro, Brunella ;
Soro, Ornella ;
Cauda, Roberto ;
Viscoli, Claudio ;
Tumbarello, Mario .
DIAGNOSTIC MICROBIOLOGY AND INFECTIOUS DISEASE, 2007, 58 (03) :325-331
[3]
Antifungal prophylaxis with azoles in high-risk, surgical intensive care unit patients: A meta-analysis of randomized, placebo-controlled trials [J].
Vardakas, KZ ;
Samonis, G ;
Michalopoulos, A ;
Soteriades, ES ;
Falagas, ME .
CRITICAL CARE MEDICINE, 2006, 34 (04) :1216-1224
[4]
Epidemiology and antifungal susceptibility of Candida species isolated from blood:: results of a 2-year multicentre study in Spain [J].
Pemán, J ;
Cantón, E ;
Gobernado, M .
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2005, 24 (01) :23-30
[5]
Epidemiology of candidaemia in Europe: Results of 28-month European Confederation of Medical Mycology (ECMM) hospital-based surveillance study [J].
Tortorano, AM ;
Peman, J ;
Bernhardt, H ;
Klingspor, L ;
Kibbler, CC ;
Faure, O ;
Biraghi, E ;
Canton, E ;
Zimmermann, K ;
Seaton, S ;
Grillot, R .
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES, 2004, 23 (04) :317-322