Oropharyngeal candidiasis in the era of antiretroviral therapy.
Oropharyngeal candidiasis in the era of antiretroviral therapy.
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抗逆转录病毒治疗时代的口咽念珠菌病。
DOI：
10.1016/j.tripleo.2009.11.026
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发表时间：
2010-04
期刊：
影响因子：
--
通讯作者：
Patterson TF
中科院分区：
文献类型：
--
作者：
Thompson GR 3rd;Patel PK;Kirkpatrick WR;Westbrook SD;Berg D;Erlandsen J;Redding SW;Patterson TF
口咽念珠菌病（OPC）仍然是一个常见的问题，在艾滋病毒感染的人口，尽管抗逆转录病毒治疗（ART）的可用性。虽然白色念珠菌是最常见的致病菌，其他念珠菌属。也可能导致感染。在这些致病酵母菌中出现抗真菌耐药性，特别是在复发性口咽感染或长期使用抗真菌治疗的患者中，需要替代抗真菌药物的工作知识。感染微生物的鉴定和抗真菌药敏试验增强了临床医生处方适当抗真菌治疗的能力。负责机制的表征提高了我们对抗真菌药物耐药性发展的理解，并可以加强对这些感染的管理。免疫重建已被证明可以降低口咽念珠菌病的发病率，但目前很少有研究评估ART对这些患者口咽念珠菌病流行病学和抗真菌药物耐药性的影响。一项正在进行的临床研究的初步结果显示，在晚期艾滋病患者中，口腔酵母菌定植广泛，在研究的122名患者中有81.1%发生，三分之一发生症状性感染。此外，耐药酵母菌仍然常见于25.3%的酵母菌定植或有症状感染的患者中。因此，口咽念珠菌病仍然是一个显着的感染，在先进的艾滋病，即使与ART。目前的流行病学知识，发病机制，临床表现，治疗和抗真菌药物耐药观察口咽念珠菌病的机制是重要的，在管理这种感染的患者，是本次审查的重点。
Oropharyngeal candidiasis (OPC) remains a common problem in the HIV-infected population despite the availability of antiretroviral therapy (ART). Although Candida albicans is the most frequently implicated pathogen, other Candida spp. may also cause infection. The emergence of antifungal resistance within these causative yeasts, especially in patients with recurrent oropharyngeal infection or with long-term use of antifungal therapies, requires a working knowledge of alternative antifungal agents. Identification of the infecting organism and antifungal susceptibility testing enhances the ability of clinicians to prescribe appropriate antifungal therapy. Characterization of the responsible mechanisms has improved our understanding of the development of antifungal resistance and could enhance the management of these infections. Immune reconstitution has been shown to reduce rates of oropharyngeal candidiasis but few studies have evaluated the current impact of ART on the epidemiology of oropharyngeal candidiasis and antifungal resistance in these patients. Preliminary results from an ongoing clinical study showed that in patients with advanced AIDS oral yeast colonization was extensive, occurring in 81.1% of the 122 patients studied and symptomatic infection occurred in a third. In addition, resistant yeasts were still common occurring in 25.3% of patients colonized with yeasts or with symptomatic infection. Thus, oropharyngeal candidasis remains a significant infection in advanced AIDS even with ART. Current knowledge of the epidemiology, pathogenesis, clinical presentation, treatment, and mechanisms of antifungal resistance observed in oropharyngeal candidiasis are important in managing patients with this infection and are the focus of this review.
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影响因子：
3.2
作者：
DOUGLAS, CM;MARRINAN, JA;KURTZ, MB
通讯作者：
KURTZ, MB
影响因子：
168.9
作者：
Cameron, DW;Heath-Chiozzi, M;Leonard, J
通讯作者：
Leonard, J
DOI：
10.1097/00126334-199905010-00003
发表时间：
1999-05-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
Cauda, R;Tacconelli, E;Cassone, A
通讯作者：
Cassone, A
影响因子：
11.8
作者：
Krause, DS;Simjee, AE;Henkel, T
通讯作者：
Henkel, T
影响因子：
3.8
作者：
Kerdpon, D;Pongsiriwet, S;Robison, V
通讯作者：
Robison, V