【精品】念珠菌诊治指南(温州).pptx

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

Epidemiologyofcandidemiain

intensivecareunits

InternationalJournalofAntimicrobialAgents32Suppl.2(2008)S87-S91

Year

Fig.1.EvolutionoftheepisodesofcandidemiaatHospitalGregorioMaranón,Madrid,1985-2007.

withcand

0

Fig.2.DistibutionofcandidemiafingemiaoverdifferentICUsatHospitalGregorioMaraion,Madnid,1985-2005

No.ofptswithcandidemia

Year

Fig.3.DistributionofCandidaspeciescausingfungemiainastudyreportedbyAlmiranteetal.fromBarcelona,Spain[8].

AgrowingproportionofepisodesofcandidemiahavebeencausedbyCandidaspeciesotherthanalbicans.

Epidemiology,management,andriskfactors

fordeathofinvasiveCandidainfectionsin

criticalcare:Amulticenter,prospective,

observationalstudyinFrance(2005-2006)

(CritCareMed2009;37:1612-1618)

OnehundredeightyICUsinFrance.

BetweenOctober2005andMay2006,300

adultpatientswithproveninvasiveCandidainfection.

·

·

·

·107(39.5%)patientswithisolated

candidemia,

·87(32.1%)withinvasivecandidiasiswithoutdocumentedcandidemia,

·77(28.4%)withinvasivecandidiasisand

candidemia.

In37%ofthecases,candidemia

occurredwithinthefirst5daysafterICUadmission.

·

80%

60%

40%

20%

0%

16%

30%

4%

8%

47%

75%

6%

100%

23%

40%

NaiveExposedNaveEposedNakeExposdNalneEφosedNaiveEposed

□S-DDorR

oS

29

158

7

16

4

96

1

12

16

18

3

1

1182

170273

FgureL.InvitrosusceptibilitytofuconazoleofselectedCandidaspeciesinpatientsnaiveforzoleagentsandinpatientspreviousyexposedtoazole

agents.S,susceptible;S-DD,susceptible-dosedependent;R,resistant.

AICandidaCabicansCgabaaCparapsiosisOtherCandidaspp

p=.07

nofisolatesof