侵袭性念珠菌感染流行病学现状和治疗进展  

Epidemiological status and advances in the treatment of invasive candidiasis

作　　者：扈东营 姜伟伟[1] 李航 王会伟 陈显振 方文捷[1] 张蕾[1] 潘炜华[1] 廖万清[1] HU Dong-ying;JIANG Wei-wei;LI Hang;WANG Hui-wei;CHEN Xian-zhen;FANG Wen-jie;ZHANG Lei;PAN Wei-hua;LIAO Wan-qing(Department of Dermatology,Shanghai Changzheng Hospital,Shanghai 200003,China)

机构地区：[1]上海长征医院皮肤科,上海200003

出　　处：《世界临床药物》2020年第5期323-328,共6页World Clinical Drug

基　　金：国家传染病科技重大专项(2018ZX10101003);上海市重中之重临床医学中心(2017ZZ01024-001);上海市医学真菌分子生物学重点实验室(17DZ2272900);国家自然科学基金(31770161);上海市扬帆计划(19YF1448000);中国工程院战略咨询课题(2019-XY-33,19-HNXZ-06,2020-XY-61-01)。

摘　　要：侵袭性念珠菌感染(invasive candidiasis,IC)是临床较常见的侵袭性真菌感染,具有发病率高、死亡率高和诊疗费用高等特点。白念珠菌虽然仍是IC患者最常见的病原菌,但近年来非白念珠菌感染发生率正逐步上升,且存在引起暴发的潜在威胁。临床常用的系统抗真菌药物主要包括三唑类、多烯类及棘白菌素类等,其中棘白菌素类是目前治疗IC的首选药物。随着抗真菌药物在临床的大量使用,念珠菌属的耐药性日趋严重,“超级真菌”耳念珠菌等新病原体不断涌现。上述抗真菌药物已无法满足临床需求,IC患者死亡率仍居高不下。本文主要对IC的流行病学现状、治疗及新药研究进展进行综述,为IC的临床诊治提供参考。Invasive candidiasis(IC)is the most common invasive fungal infection,with high morbidity,high mortality,high diagnosis and treatment costs.Candida albicans is still the most frequent etiologic agent in IC patients,but the incidence of non-albicans is gradually increasing in recent years and these species have the potential to cause outbreaks.Currently available systemic antifungal drugs mainly include triazoles,polyenes and echinocandins,among which echinocandins are the leading choices for IC.With the extensive use of antifungal drugs in clinic,drug resistance of Candida is increasing.Meanwhile,new etiologic agents,such as the super fungi Candida auris,are emerging.The above antifungal drugs have been unable to meet clinical needs and mortality of IC remains high.This article mainly reviewed the epidemiological status,treatment and new drug research progress of IC,providing references for the diagnosis and treatment in clinic.

关 键 词：侵袭性念珠菌感染 流行病学 抗真菌药物 耐药性 

分 类 号：R519.3[医药卫生—内科学]