血液学疾病突破性淋巴瘤:来自日本单中心回顾性研究的结果,2009-2020年
Ruriko Nishida1, Yoshihiro Eriguchi1, Noriko Miyake1
1Department of Medicine and Biosystemic Science, Kyushu University Graduate School of Medical Science, Fukuoka, Japan.
Medical mycology
|June 14, 2023
概括
血液病患者的突破性候选血症通常是由Candida guilliermondii复合体和Candida parapsilosis引起的,它们显示出 Echinocandin 易感性降低. 血造干细胞移植患者因这种感染而面临更高的死亡率.
科学领域:
- 医学真菌学 医学真菌学
- 传染性疾病 传染性疾病
- 血液学 血液学 血液学
背景情况:
- 突破性候群病 (BrC) 对免疫受损的个体构成重大威胁,特别是那些患有血液学疾病的人.
- 埃奇诺坎丁抗真菌剂经常用于治疗BrC,但新出现的耐药性是令人担忧的.
研究的目的:
- 用新型抗真菌剂治疗的血液病患者的BrC的特征.
- 研究抗真菌耐药性和患者特征对结果的影响.
主要方法:
- 从2009年至2020年间,对患有血液病的患者进行了40例BrC病例的回顾性分析.
- 临床和微生物学数据收集,包括抗真菌敏感性测试和遗传分析 (FKS多态).
主要成果:
- 最常见的分离物是Candida guilliermondii复合物 (32.5%) 和Candida parapsilosis (30%).这些分离物是最常见的分离物.
- 这些物种表现出由于FKS基因多态性而减少了 echinocandin 易感性,尽管 in vitro 易感性.
- 接受血造干细胞移植 (HSCT) 相关治疗的患者的30天死亡率 (55.2%) 与未接受治疗 (18.2%) 相比显著更高.
- 在用乙甘治疗的HSCT患者中,C. guilliermondii复杂BrC的死亡率高 (53.8%) 和持续感染的风险.
结论:
- 坎迪达 (Candida guilliermondii) 复杂突破性候选病是HSCT患者的潜在致命病症,特别是当他们接受了 echinocandins 治疗时.
- 像C. guilliermondii复合体这样的 Echinocandin 降低敏感菌株的流行可能与广泛的 Echinocandin 使用有关.
- 需要进一步研究免疫功能低下患者耐药性候选血症的最佳治疗策略.
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