Trichosporonosis in a tertiary care cancer center: Risk factors, changing spectrum and determinants of outcome
Trichosporonosis in a tertiary care cancer center: Risk factors, changing spectrum and determinants of outcome
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DOI：
10.1080/00365540410017563
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发表时间：
2004-08-01
影响因子：
--
通讯作者：
Raad, II
中科院分区：
文献类型：
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作者：
Kontoyiannis, DP;Torres, HA;Raad, II
为了评估癌症患者毛孢子菌病（TS）的谱和结果，我们回顾了17例此类TS患者的病历。TS最常见的表现为真菌血症（n = 10，包括7例中心静脉导管相关感染）和肺部或软组织感染（各n = 3）。大多数患者（65%）患有急性白血病，11例（65%）患有中性粒细胞减少症，9例（53%）接受了高剂量皮质类固醇。10例患者在接受以下至少一种药物治疗期间发生了突破性TS：阿替霉素B、氟康唑、伊曲康唑和伏立康唑。30天的粗死亡率为53%。单变量分析的死亡率预测因素包括：高APACHE II评分中位数（p< 0.01）、使用高剂量皮质类固醇（p = 0.01）和入住重症监护室（p< 0.01）。TS与癌症患者的高死亡率相关。我们机构的感染谱已经从以播散性感染为主转变为CVC相关的真菌血症，而没有组织侵入的证据。
To assess the spectrum and outcome of trichosporonosis (TS) in cancer patients, we reviewed the medical records of 17 such patients with TS. TS presented most commonly as fungemia ( n = 10, including 7 with central-venous-catheter - related infection) and either pulmonary or soft tissue infection ( n = 3, each). Most patients (65%) had acute leukemia, 11 ( 65%) had neutropenia, and 9 (53%) had received high doses of corticosteroids. 10 patients had breakthrough TS during therapy with at least 1 of the following: amphotericin B, fluconazole, itraconazole, and voriconazole. The 30-d crude mortality rate was 53%. Predictors of mortality by using univariate analysis included: high median APACHE II score ( p< 0.01), use of high dose of corticosteroids ( p = 0.01), and admission to the intensive care unit ( p< 0.01). TS is associated with a high mortality rate in cancer patients. The spectrum of infection at our institution has shifted from a predominance of disseminated infection to CVC-related fungemias without evidence of tissue invasion.