摘要
目的:探讨念珠菌败血症的临床特点、菌株构成、危险因素及治疗转归。方法:收集2001～2005年间血培养念珠菌阳性的临床病例资料进行回顾性分析。结果:血培养念珠菌阳性共45例,以白色念珠菌为主,其次为热带念珠菌,病原学长期趋势显示白色念珠菌呈下降趋势,而非白色念珠菌逐年上升;药物敏感试验表明耐氟康唑白色念珠菌占58.3%。所有病例均有严重基础疾患,长期使用广谱抗生素(93.3%)、血管内置管(37.3%)为主要易感因素;老年、嗜中性粒细胞减少、低白蛋白血症、肾功能衰竭、感染性休克、多重感染是预后不良的信号。氟康唑为主要治疗药物,总病死率55.6%。结论:氟康唑不能作为所有念珠菌感染的首选药物,应重视病原学及药物敏感试验,合理选用抗真菌药物,采用综合性治疗措施,早期、足量、足疗程进行抗真菌治疗。
Objective：To investigate the etiology, clinical characteristics, risk factors and outcome of candidemia. Methods： The clinical data of 45 cases of blood cultivation positive patients from January 2001 to December 2005 were analyzed retrospectively. Results. Among 45 cases, the most frequently isolated organism was C. albicans （37.8%）, followed by C. tropicalis. Secular trends in etiology showed a sustaining decrease of C. albicans and increase of non-albicans Candida responsibly. Haematological disease was the most common underlying condition. The majority of the cases had received 3 or more broad-spectrum antibiotics （93.3%） and intravascular catheters （37.3%）. The risk factors for high motality included age, neutropenia, hypoadlbuminemia, renal failure and septic shock. Fluconazole was the main therapeutic method to treat candidemia. The overall mortality of candidemia was 55.6%. Conclusion： Fluconazole can not be the first choice for all candidemia. The blood culture and the drug sensitive test should be performed routinely to provide proper evidence for antifungal therapy. Effective and reasonable therapeutics are the guarantee for reducing the mortality of the candidemia.
出处
《南京医科大学学报（自然科学版）》
CAS
CSCD
北大核心
2006年第9期795-798,共4页
Journal of Nanjing Medical University(Natural Sciences)
