Drug-Resistant Candida glabrata Infection in Cancer Patients (http://wwwnc.cdc.gov/eid/article/20/11/14-0685)

Dimitrios Farmakiotis; Jeffrey J Tarrand; Dimitrios P Kontoyiannis

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Drug-Resistant Candida glabrata Infection in Cancer Patients (http://wwwnc.cdc.gov/eid/article/20/11/14-0685)

机译：癌症患者的耐药性光滑念珠菌感染（http://wwwnc.cdc.gov/eid/article/20/11/14-0685）

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Cancer patients are at risk for candidemia, and increas- ing Candida spp. resistance poses an emerging threat. We determined rates of antifungal drug resistance, identified factors associated with resistance, and investigated the correlation between resistance and all-cause mortality rates among cancer patients with ≥1 C. glabrata –positive blood culture at MD Anderson Cancer Center, Houston, Texas, USA, during March 2005–September 2013. Of 146 isolates, 30 (20.5%) were resistant to fluconazole, 15 (10.3%) to ca- spofungin, and 10 (6.8%) to multiple drugs (9 caspofungin- resistant isolates were also resistant to fluconazole, 1 to amphotericin B). Independently associated with fluconazole resistance were azole preexposure, hematologic malignan- cy, and mechanical ventilation. Independently associated with caspofungin resistance were echinocandin preexpo- sure, monocytopenia, and total parenteral nutrition. Fluco- nazole resistance was highly associated with caspofungin resistance, independent of prior azole or echinocandin use. Caspofungin resistance was associated with increased 28- day all-cause mortality rates. These findings highlight the need for good stewardship of antifungal drugs.

机译：癌症患者有念珠菌血症的风险，并增加了念珠菌的数量。抵抗带来了新的威胁。我们在美国德克萨斯州休斯顿的MD Anderson癌症中心确定了≥1C. glabrata-阳性血液培养的癌症患者中抗真菌药物耐药率，已确定与耐药相关的因素，并研究了耐药与全因死亡率之间的相关性，在2005年3月至2013年9月期间。在146株菌株中，氟康唑耐药30株（20.5％），对卡泊芬净耐药15株（10.3％），对多种药物耐药10株（6.8％）（9株对卡泊芬净耐药的菌株也耐药氟康唑，1到两性霉素B）。与氟康唑耐药性独立相关的是唑类预暴露，血液系统恶性肿瘤和机械通气。与棘孢菌素抗药性独立相关的是棘球菌素暴露前，单细胞减少症和全胃肠外营养。氟康唑的耐药性与卡泊芬净的耐药性高度相关，而与先前的吡咯或echinocandin的使用无关。卡泊芬净耐药与28天全因死亡率增加相关。这些发现强调了抗真菌药物的良好管理的必要性。

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《Emerging Infectious Diseases》 |2014年第11期|共8页
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Dimitrios Farmakiotis; Jeffrey J Tarrand; Dimitrios P Kontoyiannis;
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机译：癌症患者的耐药性光滑念珠菌感染
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Drug-Resistant Candida glabrata Infection in Cancer Patients (http://wwwnc.cdc.gov/eid/article/20/11/14-0685)

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