Oropharyngeal and esophageal candidiasis in immunocompromised patients: Treatment issues
Oropharyngeal and esophageal candidiasis in immunocompromised patients: Treatment issues
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DOI：
10.1086/516315
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发表时间：
1998-02-01
影响因子：
11.8
通讯作者：
Darouiche, RO
中科院分区：
文献类型：
--
作者：
Darouiche, RO
真菌感染的发病率，特别是由念珠菌属引起的真菌感染，在过去15年中显著增加[1]。虽然最近使用的联合抗逆转录病毒治疗，包括蛋白酶抑制剂可能有助于扭转这种模式，念珠菌感染是目前最常见的真菌感染的患者与艾滋病毒感染和艾滋病[1]。虽然大多数念珠菌病仍然是由C。白色念珠菌，非白色念珠菌物种（主要是念珠菌）的频率显著增加。tropi-calis，C. krusei，克鲁塞伊C.近平滑C. glabrata）是分离的[2]。例如，在20世纪80年代末，非白色念珠菌株仅占HIV感染患者口咽分离株的3.4%，而到1990年初，这一比例为16.8%，3年内增加了4倍[3]。最近对37篇出版物的综述显示，癌症患者中几乎一半（46%）的念珠菌感染是由非白色念珠菌引起的[4]。口咽念珠菌病是HIV感染患者中最常见的机会性感染，在HIV疾病过程中的某个时间点发生在多达90%的HIV阳性患者中[5]。与一般真菌感染的总体模式一致，据报道口咽念珠菌病的发病率随时间稳步上升。国家卫生统计中心、国家医院出院调查和两个商业生成的医院出院数据源对1980年至1989年的医院出院数据的最新分析（PAS [专业活动调查]和McAuto [McDonnell道格拉斯自动化公司医疗记录系统]）显示，口咽念珠菌病的发病率几乎增加了五倍（从1980年至1989年的每年每1,000名住院患者中有0.34例病例到每年每1,000名住院患者中有1.6例病例）[6]。
The incidence of fungal infections, particularly those caused by Candida species, has increased markedly over the past 15 years [1]. Although the recent use of combination antiretroviral therapy that includes protease inhibitors may help reverse this pattern, candidal infections are currently by far the most common fungal infections in patients with HIV infection and AIDS [1]. While most cases of candidiasis are still caused by C. albicans, there has been a striking increase in the frequency with which non-albicans Candida species (primarily C. tropi-calis, C. krusei, C. parapsilosis, and C. glabrata) are isolated [2]. For example, non-albicans strains of Candida accounted for only 3.4% of oropharyngeal isolates from HIV-infected patients in the late 1980s, as compared with 16.8% of isolates by the beginning of 1990-a fourfold increase in 3 years [3]. A recent review of 37 publications revealed that almost half (46%) of all candidal infections in patients with cancer were caused by non-albicans species of Candida [4]. Oropharyngeal candidiasis is the most common opportunistic infection in patients with HIV infection, occurring in as many as 90% of HIV-positive patients at some point during the course of HIV disease [5]. Consistent with the overall pattern of fungal infections in general, the incidence of oropharyngeal candidiasis has reportedly risen steadily over time. A recent analysis of hospital discharge data from 1980 to 1989 by the National Center for Health Statistics, National Hospital Discharge Survey, and two commercially-generated hospital discharge data sources (PAS [Professional Activity Survey] and McAuto [McDonnell Douglas Automation Company Medical Records System]) revealed that the rate of oropharyngeal candidiasis increased almost fivefold (from 0.34 cases per 1,000 admissions per year to 1.6 cases per 1,000 admissions per year) from 1980 to 1989 [6].