肝移植受体真菌感染的流行病学特点及防治策略  

Epidemiology of fungal infection and preventive strategy in liver transplantation

作　　者：钟林[1] 彭志海[1] 丁星[1] 易俊文[1] 柯群[1] 朱泽航[1] 

机构地区：[1]交通大学附属第一人民医院肝移植中心

出　　处：《上海医学》2004年第11期802-804,共3页Shanghai Medical Journal

摘　　要：目的　探讨肝移植术后真菌感染的病原学特点 ,为临床经验性治疗提供参考。方法　回顾性分析2 0 0 1年 1月～ 2 0 0 4年 6月 2 5 0例肝移植受体标本中病原学的检出情况。结果　 2 5 0例肝移植手术标本中共分离出 12 6株真菌 ,其中酵母菌占 94 % (119/ 12 6株 ) ,以白色念珠菌为主 ,但耐氟康唑酵母菌如克柔酵母菌、近平滑酵母菌、热带酵母菌、季也蒙酵母菌增多。非酵母菌有土生隐球菌 (4株 )、新隐球菌 (2株 )、曲霉菌 (1株 )。真菌培养率与感染率不平衡 ,真菌感染率仅为 17.2 % ,以 3个月内多见 (38/ 4 3例 ) ,感染的真菌主要为白色念珠菌、耐氟康唑酵母菌、曲霉菌 ,感染部位主要为呼吸道、腹腔、胆道。Objective To evaluate the epidemiology of fungal infections in liver transplantation, and to provide a fundamentism for prophylaxis and empirical therapy.Methods A retrospective survey of pathogen detection from recipient specimens in 250 operations for liver transplantation from January 2001 to July 2004. Results The most common pathogens were Candida accounted for 94%(119/126) in 126 fungal strains isolated from liver transplant recipients. The most prevalent candida cultured was Candida albicans and other drug-resistant candida were Candida krusei,Candida parapsilosis,Candida tropicalis and Candida guilliermondii. The non-candida found were Cryptococcus neoformans(2),Cryptococcus humicolus(4) and Aspergillus(1). Invasive fungal infection were present in 17.2% of liver transplant patients which occurred within 3 months after transplantation(38/43). The leading pathogens were Candida albicans, drug-resistant candida and Aspergillus. The most common infectious sites involved the respiratory tract, abdominal cavity and biliary tract.Conclusion The survey strengthening the surveillance on epidemiology of fungal infections in liver transplant repicients can guide rational clinical therapy. (Shanghai Med J, 2004,27∶802-804)

关 键 词：肝移植 真菌感染 受体 隐球菌 氟康唑 白色念珠菌 酵母菌 标本 曲霉菌 热带 

分 类 号：R657.3[医药卫生—外科学] R519[医药卫生—临床医学]