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首页> 外文期刊>Scandinavian journal of infectious diseases. >Prospective study of fungaemia in a single cancer institution over a 10-y period: aetiology, risk factors, consumption of antifungals and outcome in 140 patients.
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Prospective study of fungaemia in a single cancer institution over a 10-y period: aetiology, risk factors, consumption of antifungals and outcome in 140 patients.

机译：在单个癌症机构中进行为期10年的真菌血症的前瞻性研究：病因，危险因素，抗真菌药物的消耗和140例患者的结局。

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摘要

Over a 10-y period (1989-99) we prospectively evaluated all patients with fungaemia among 16,555 admissions (21,004 blood cultures) at a national cancer referral institution in the Slovak Republic. A prospective protocol was completed on 140 patients with fungaemia, which was then analysed in terms of aetiology, clinical characteristics, potential risk factors and outcome. The most frequently isolated organism was C. albicans, in 75 patients (52.9%), followed by non-albicans Candida spp. in 45 patients (32.1%). Non-Candida spp. yeasts represented 16 episodes in 16 patients (11.4%). Moulds caused 4 episodes in 4 patients (3.6% of all fungaemias) and all were caused by Fusarium spp. Mucositis (p = 0.025), > or = 3 positive blood cultures (p = 0.02), acute leukaemia (p = 0.00001), neutropenia (p = 0.0015), quinolone prophylaxis (p ` 0.000005) and breakthrough fungaemia (p = 0.004) during prophylaxis with fluconazole (p = 0.03) and itraconazole (p = 0.005) were significantly more associated with non-Candida than C. albicans spp. Furthermore, attributable mortality was higher in the subgroup of non-Candida than C. albicans spp. (50.0 vs. 18.7%, p < 0.02). The only independent risk factor for inferior outcome was antifungal therapy of < 10 d duration (odds ratio 2.1, 95% confidence interval, p < 0.001). Aetiology, neutropenia and mucositis were not independent risk factors for higher mortality in multivariate analysis; however, they were risk factors for inferior outcome in univariate analysis (p < 0.05-0.005).
机译：在10年期间（1989-99年），我们在斯洛伐克共和国的一家国家癌症转诊机构中对16,555例入院（21,004血培养）中的所有真菌病患者进行了前瞻性评估。对140名真菌病患者完成了一项前瞻性研究，然后根据病因，临床特征，潜在危险因素和结果进行了分析。最常见的细菌是白色念珠菌，占75例（52.9％），其次是非白色念珠菌。在45例患者中（32.1％）。非念珠菌属酵母菌在16例患者中占16例（11.4％）。霉菌在4例患者中引起4次发作（占全部真菌病的3.6％），并且都是由镰刀菌引起的。粘膜炎（p = 0.025），≥3种阳性血液培养（p = 0.02），急性白血病（p = 0.00001），中性粒细胞减少症（p = 0.0015），喹诺酮类药物预防（p`0.000005）和突破性真菌病（p = 0.004）氟康唑（p = 0.03）和伊曲康唑（p = 0.005）预防期间与非念珠菌的相关性比白色念珠菌更明显。此外，非念珠菌亚组的归因死亡率高于白色念珠菌。 （50.0 vs. 18.7％，p <0.02）。不良结果的唯一独立危险因素是持续时间少于10 d的抗真菌治疗（赔率2.1，95％置信区间，p <0.001）。在多变量分析中，病因，中性粒细胞减少和粘膜炎不是导致较高死亡率的独立危险因素。然而，它们是单因素分析结果差的危险因素（p <0.05-0.005）。

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