系统性抗叶酸化学疗法不能选择抗可纳的候选菌:一个多中心临床研究
Dawid Żyrek1, Joanna Nowicka2, Magdalena Pajączkowska2
1Department of Histology, Institute of Medical Sciences, University of Opole, 45-052 Opole, Poland.
Pathogens (Basel, Switzerland)
|June 25, 2025
概括
系统性抗叶酸治疗佩米特雷克塞德或美托特雷克塞特并不会增加癌症患者抗可纳耐药酵母菌殖民或感染的风险. 在体外耐药性并不转化为体外临床风险.
科学领域:
- 医学真菌学 医学真菌学
- 抗真菌耐药性 抗真菌耐药性
- 癌症治疗方法 癌症治疗方法
背景情况:
- 之前的体外研究表明,叶酸抗剂,如甲醇,可以诱导Candida物种对醇抗真菌剂的多药性耐药性.
- 抗瘤抗叶剂,如甲基和pemetrexed,用于癌症治疗.
- 在体外观察到的抗真菌耐药性在体内观察到的抗真菌耐药性的临床意义仍然不清楚.
研究的目的:
- 调查系统性抗叶酸治疗 (甲基或佩姆特雷克斯) 是否是产生抗可纳耐药酵母菌殖民或感染的风险因素.
- 评估抗叶酸治疗对内源酵母中醇耐药性发展的体内影响.
主要方法:
- 一项涉及44名接受高剂量抗叶酸治疗的癌症患者和48名没有接触抗叶酸的对照者的病例控制研究.
- 收集所有参与者的口腔拭子和临床数据.
- 对来自13种真菌菌株的109个真菌菌株进行隔离,鉴定和可纳敏感性测试.
主要成果:
- 在接受抗叶酸治疗的9.1%的患者和6.3%的对照患者中发现了抗黄素耐药的酵母分离物.
- 在两组之间,在抗可纳酵母的患病率上没有统计学上显著的差异.
- 该研究在所有隔离物中确定了13种不同的真菌物种.
结论:
- 系统性抗质抗叶剂疗法似乎不会在体内内源性酵母菌种中诱导醇耐药性.
- 抗叶酸诱导的醇交叉耐药性的体外现象并没有转化为癌症患者中具有临床意义的抗可纳耐药酵母感染风险增加.
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