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华西医学  2011 

季也蒙念珠菌感染临床分析

, PP. 34-37

Keywords: 季也蒙念珠菌,病原菌,真菌病

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Abstract:

【】 目的 对季也蒙念珠菌感染患者的临床及微生物学特征进行分析,为临床诊治提供参考。 方法 收集2006年1月-2008年12月病原菌培养为季也蒙念珠菌的10例住院患者资料进行回顾性分析。 结果 季也蒙念珠菌感染患者存在多种基础疾病,大多数患者(8/10)有易感因素,其中7例使用广谱抗菌药物。10例中有8例为深部真菌感染。其临床表现与感染部位有关,主要累及泌尿道、呼吸道和皮肤软组织。多数深部感染患者(6/8)在感染前存在同部位细菌感染,部分患者(3/8)在相同部位还可分离出其他真菌。全部季也蒙念珠菌菌株对两性霉素B敏感,大多数菌株(9/10)对氟康唑敏感。仅1例患者因肺部感染、呼吸衰竭死亡,其余患者经氟康唑、伊曲康唑或特比萘芬等抗真菌药物治愈。 结论 季也蒙念珠菌感染多发生于有基础疾病、存在真菌易感因素者,感染部位多为原细菌感染部位,常合并其他细菌或真菌感染。部分菌株对氟康唑和伊曲康唑中敏或耐药,治疗应根据药敏进行选择。?【Abstract】 Objective Toanalyzetheclinicalandmicrobiologiccharactersofcandidaguilliermondiitoimprovetheclinicaldiagnosisandtreatment. Methods Theclinicaldataof10patientswithcandidaguilliermondiiinfectiondiagnosedinourhospitalfromJanuary2006toDecember2008wereretrospectivelyanalyzed. Results Allthepatientshadseveralunderlyingconditions;eightpatientshadpredisposingfactorsandsevenpatientswereprescribedwithbroad-spectrumantibacterials.Eightpatientshaddeepmycoses,whoseclinicalmanifestationwasassociatedwiththeinfectioussites,mainlyinvolvedinurinarytract,respiratorytractandskin-softtissues.Mostdeepmycoses(6/8)hadpriorbacterialinfectionatthecandidaguilliermondiiinfectionsite;somepatients(3/8)hadotherfungousinfectionatthesametime.AllthestrainsweresensitivetoamphotericinB;mostfungousstrains(9/10)weresensitivetofluconazole.Onepatientdiedofpulmonaryinfectionandrespiratoryfailure,andtheotherswerecuredbyfluconazole,itraconazoleorterbinafine. Conclusion Candidaguilliermondiiinfectionmainlyoccursinpatientswithunderlyingconditionsandpredisposingfactors.Theinfectioussiteshavepriorbacterialinfectionandbacterialinfectionorfungousinfectionatthesametime.Sincesomecandidaguilliermondiistrainswerenotsensitivetofluconazoleanditraconzole,drugsensitivetestshouldbeconsulted.?

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