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【medical-news】阿萨希毛孢子菌：抗真菌治疗就万
Dept. of Microbiology and Clinical Microbiology, Karadeniz Technical University, School of Medicine, 6180, Trabzon, Turkey, gulcinbay@hotmail.com.
A 47-year-old man with newly diagnosed acute myeloblastic leukemia and non-insulin-dependent diabetes mellitus developed Trichosporon asahii fungemia while receiving caspofungin as empirical antifungal therapy. The diagnosis was based on repeated isolation of T. asahii in culture of blood for three times. Despite treatment with amphotericin B and voriconazole, the patient died. The in vitro antifungal susceptibilities of the T. asahii isolates were only available after the patient died. In vitro antifungal susceptibility tests showed high caspofungin and amphotericin B minimal inhibitory concentrations (MICs) value for this Trichosporon strain (MICs, 16 microg/ml, and > 32 microg/ml, respectively). Fluconazole, itraconazole, and voriconazole exhibited low MICs in vitro (MICs, 4 microg/ml, 0.5 microg/ml, and </= 0.015 microg/ml, respectively). Our experience strongly suggest that identification and antifungal susceptibility testing for T. asahii in neutropenic patients who may develop signs of infection in the presence of caspofungin as well as broad-spectrum antibiotics treatment should not be overlooked
http://www.docguide.com/news/content.nsf/PaperFrameSet?OpenForm&newsid=852571020057CCF68525735E003F85CE&topabstract=1&u=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Abstract&list_uids=17882360 认领！ 一位47岁的患者原诊为急性粒细胞白血病和非胰岛素依赖型糖尿病，继发阿萨希毛孢子菌血症，之后接受卡泊芬净作为经典的抗真菌治疗。诊断十分明确，三次实验室检查均在血液分离出阿萨希毛孢子菌。尽管用两性霉素B和伏立康唑联合治疗，患者依然死亡了。在体外抗真菌药敏试验的需要的分离出的阿萨希毛孢子菌菌株只能在患者死亡后提供。体外药敏试验表明，卡泊芬净和两性霉素b最小抑菌浓度（MICs）对杀灭为这一菌株都有很高的价值（MICs分别为， 16 μ /毫升， > 32 μ /毫升，） 。氟康唑，伊曲康唑，伏立康唑在体外呈现较低的最小抑菌浓度（MICs分别为， 4 μ /毫升， 0.5 μ /毫升，而< / = 0.015 μ /毫升） 。根据我们的经验强烈建议，已经有迹象显示感染了阿萨希毛孢子菌的粒细胞白血病的患者，提倡使用卡泊芬净以及广谱抗生素的治疗联合治疗。 感觉有几处都不太懂，希望各位达人指教 [标签:content1][标签:content2]
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作者:admin@医学,生命科学 2011-06-22 17:18
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