EPIDEMIOLOGY OF NOSOCOMIAL FUNGAL-INFECTIONS, WITH EMPHASIS ON CANDIDA SPECIES
EPIDEMIOLOGY OF NOSOCOMIAL FUNGAL-INFECTIONS, WITH EMPHASIS ON CANDIDA SPECIES
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DOI：
10.1093/clinids/20.6.1526
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发表时间：
1995-06-01
影响因子：
11.8
通讯作者：
JARVIS, WR
中科院分区：
文献类型：
--
作者：
JARVIS, WR
目前，全国约有180家医院参加了医院感染监测系统（NNIS）。从1980年1月至1990年4月，这些医院共报告了27，200株引起医院感染的真菌;念珠菌19621株（72.1%），免疫功能低下的患者发生念珠菌血症的风险特别高，在急性淋巴细胞白血病患者中，万古霉素和/或亚胺培南治疗似乎是念珠菌血症的独立危险因素;念珠菌属在粪便中定植可能是这些患者的另一个重要诱发因素。快速检测这些高危患者的侵袭性念珠菌血症对于提高生存率尤其重要，快速检测方法，例如甘露聚糖（念珠菌的主要细胞壁多糖）的测量，可能有助于诊断侵袭性念珠菌病并监测这种感染对抗真菌治疗的反应。对危险因素的进一步研究以及快速诊断和监测新方法的开发将有助于降低与院内真菌感染相关的发病率和死亡率。
Currently, about 180 hospitals participate in the National Nosocomial Infections Surveillance (NNIS) system, From January 1980 through April 1990, 27,200 fungal isolates causing nosocomial infections were reported from these hospitals; Candida species accounted for 19,621 (72.1%) of these isolates, Immunocompromised patients are at particularly high risk for candidemia, In patients with acute lymphocytic leukemia, treatment with vancomycin and/or imipenem appears to be an independent risk factor for candidemia; colonization of stool by Candida species may be another important predisposing factor in these patients. Rapid detection of invasive candidemia in these high-risk patients is particularly important to the improvement of rates of survival, Methods for rapid detection, such as the measurement of mannan (the major cell-wall polysaccharide of Candida), may be useful for diagnosing invasive candidiasis and for monitoring the response of this infection to antifungal therapy. Further studies of risk factors and the development of new methods for rapid diagnosis and monitoring should help decrease the morbidity and mortality associated with nosocomial fungal infections.