Candiduria in haematologic malignancy patients without a urinary catheter: nothing more than a frailty marker?
Candiduria in haematologic malignancy patients without a urinary catheter: nothing more than a frailty marker?
复制标题
DOI：
10.1111/myc.12024
复制
发表时间：
2013-05-01
期刊：
影响因子：
4.9
通讯作者：
Kontoyiannis, Dimitrios P.
中科院分区：
文献类型：
--
作者：
Georgiadou, Sarah P.;Tarrand, Jeffrey;Kontoyiannis, Dimitrios P.
关于念珠菌在血液学恶性肿瘤患者中的重要性及其与侵袭性念珠菌病的关系的数据缺乏。为此，我们回顾性评估了10年间（2001 - 2011年）所有患有恶性血液病和念珠菌病的住院非重症监护病房患者。为了减少膀胱定植和样本污染的可能性，我们排除了所有使用导尿管和合并细菌尿的念珠菌病患者。24例患者（21例女性），诊断时中位年龄62岁（范围2082岁）。急性白血病是最常见的基础疾病（54%）；62%的病例没有缓解。29%的患者患有糖尿病，25%的患者患有中性粒细胞减少症。分离到的念珠菌种类以光念珠菌（37%）最多，其次是白色念珠菌（29%）。只有8%的人有尿路感染症状。然而，88%的患者接受了全身抗真菌药物治疗。4周时念珠菌和粗死亡率较低（分别为4%和12%）。血液学恶性肿瘤患者中分离的念珠菌具有与其他住院患者相似的危险因素，并且它似乎不是随后侵袭性念珠菌病的强有力预测因子。
There is scarcity of data regarding significance of candiduria in patients with haematologic malignancies and its association with invasive candidiasis. To that end, we retrospectively evaluated all hospitalised, non-intensive care unit patients with haematologic malignancies and candiduria during a 10-year period (20012011). To decrease the possibility of bladder colonisation and sample contamination, we excluded all patients with candiduria who had urinary catheters and those with concomitant bacteriuria. Twenty-four such patients (21 females) were identified, with median age at diagnosis 62years (range, 2082years). Acute leukaemia was the most common underlying disease (54%); 62% of these cases were not in remission. Twenty-nine percent of the patients had diabetes mellitus and 25% were neutropenic. The most common isolated Candida species was Candida glabrata (37%), followed by C. albicans (29%). Only 8% of them had urinary tract infection symptoms. However, 88% received systemic antifungals. Candidemia and crude mortality rates at 4weeks were low (4% and 12% respectively). Isolated candiduria in patients with haematologic malignancies has risk factors similar to those in other hospitalised patients, and it does not seem to be a strong predictor of subsequent invasive candidiasis.