念珠菌诊治指南(温州).docx

念珠菌流行病学趋势与 IDSA2009年念珠菌治疗指南 江苏省人民医院 周苏明 2011年2月27日 Epidemiology of candidemia inintensive care units International Journal of Antimicrobial Agents 32 Suppl. 2 (2008) S87-S91 85- 85- B B7 BB 69 90 91 92 93 94 95 96 97 98 99 DO 01 D2 03 04 05 0 6 i07 Year BJUJapjlpreo￡一 mujkaoaz Fig. L Evolution of the episodes of candidemia at Hospital Gregorio Maiafton. Madrid. 1985-2007. ih HLUoTJ-puraDLIl-* 通d JJO?OZ HLUoTJ-puraDLIl-* 通d JJO?OZ Fig 2. Distribution of candidcmia 血瑯m over different ICLs at Hospital Gregorio MaraMn, Madrid. I9S5-2M5. C. parapsiJosis 23% C. tropkalis 10% 匕― C fennel 4% Other —3% 丿 C. g]abrata 9% 匚 albicans 51% Fig. 3. Distribution of Candida species causing fungemia in a study reported by Almirante et aL from Barcelona. Spain [8]. Agrowing proportion of episodes of candidemia have been caused by Candida species other than albicans. Epidemiology, management, and risk factors for death of invasive Candida infections in critical care: A multicenter, prospective, observational study in France (2005-2006) (CritCare Med 2009; 37:1612-1618) One hundred eighty ICUs in France. Between October 2005 and May 2006, 300 adult patients with proven invasive Candida infection. 107 (39.5%) patients with isolated candidemia, 87 (32.1%) with invasive candidiasis without documented candidemia, 77 (28.4%) with invasive candidiasis and candidemia. In 37% of the cases, candidemia occurred within the first 5 days after ICU admission. AlC^dsfF.WC alb jeansC： g旧甘 AlC^ds fF.W C alb jeans C： g旧甘 C. pargpsAjsis Other Candids spp. Figure I. /? 湖如 測sc即hhili^ io flucoinjzo[e of selected Candida s.pecies in pjfienfc naive fnr azole agents and in ptienh prwiously seposed Io izole agents.方 susceptible; S皿 susceptible-dosfi dependent: R. Esislant. % n303120WG % n 30 31 20 W G翊潮 41 ￡ ■驴? Consensus statement on the management of invasive candidiasis in Intensive Care Units in the Asia-Pacific Region International Journal of Antimicrobial Agents 34 (2009) 205-209 -Japan (Nakamura al) ■ J