儿童急性白血病合并真菌血症病原学分析  

Aetiology analysis of pediatric acute leukemia with fungemia

作　　者：姜锦[1] 李楠[1] 姚佳峰[1] 

机构地区：[1]首都医科大学附属北京儿童医院血液肿瘤中心,北京市100045

出　　处：《中国基层医药》2014年第12期1799-1800,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的分析急性白血病患儿真菌血症的菌群分布及耐药情况，为临床诊治提供参考。方法对42例恶性肿瘤真菌血症患儿的临床资料进行回顾性分析。结果42例真菌血症中急性淋巴细胞白血病35例，急性非淋巴细胞自血病6例。念珠菌血症为真菌血症的主要病原体，占95．2％。8例合并细菌败血症，占19．0％。药物敏感试验结果显示，2例对氟康唑中介，1例对两性霉素B耐药，对伏立康唑、伊曲康唑、氟胞嘧啶均敏感。广谱抗生素的应用、中性粒细胞〈0．5×10^9／L、中心静脉置管、年龄、住院时间〉15d是引起真菌血症最主要的危险因素。结论控制易感因素是降低真菌血症发病率的有效措施，及时合理的抗真菌治疗是治疗真菌血症的主要方法。Objective To investigate the epidemiology of fungemia and provide evidence for clinical therapy. Methods A retrospective survey was done with the 42 cases of fungemia in our hospital. Results 42 cases of fungemia include 35 cases acute lymphoid leukemia,6 acute myloid leukemia. 95.2% of the fungemia pathogen agent was monilia. 8 cases combined with bacterial septicemia, accounting for 19.0%. Drug sensitivity test showed that 2 cases were intermediary to Flaconazole, 1 patient was resisdence to Amphoteriein B but sensitive to Voriconazole, Itracon- azole and fluorocytosine. The main risk factors of fungimia included using wide-spectrum antibiotic, neutophil less than 0.5 × 10^9/L, central venous indwelling catheter, age and the time of in hospital more than 15 days. Conclusion The effective measure to reduce fungemia morbitity is controlling risk factors. Timely and effectively antifungal therapy is also needed.

关 键 词：白血病 儿童 真菌血症 血传病原体 

分 类 号：R733.71[医药卫生—肿瘤]