中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2013年
4期
285-288
,共4页
刘彩霞%杨锦红%董琳%麦菁芸%张璐%朱将虎
劉綵霞%楊錦紅%董琳%麥菁蕓%張璐%硃將虎
류채하%양금홍%동림%맥정예%장로%주장호
毕赤酵母%交叉感染%真菌血症%早产%卡泊芬净
畢赤酵母%交扠感染%真菌血癥%早產%卡泊芬淨
필적효모%교차감염%진균혈증%조산%잡박분정
Pichia%Cross infection%Fungemia%Premature birth%Caspofungin
目的 分析早产儿医院获得性奥默毕赤酵母菌败血症的临床及分子生物学特点,以提高对该病的认识和治疗水平.方法 回顾性分析2010年7至11月温州医学院附属育英儿童医院新生儿重症监护病房(NICU)6例奥默毕赤酵母菌败血症患儿的临床和病原学资料；对分离株进行鉴定,用随机引物多态性分析(RAPD)进行同源性分析；同时根据医院感染流行病学特征,对患儿周围环境和物品进行采样分析.结果 6例患儿分离出奥默毕赤酵母菌前平均住院时间28 d；使用抗菌药物时间为13～45 d;6例患儿均接受静脉营养,其中4例接受机械通气,5例接受中心静脉置管.5例经卡泊芬净治疗15 ～30 d后痊愈,l例使用氟康唑30 d后痊愈.菌株经仪器鉴定和18 S rDNA序列测定确认为奥默毕赤酵母菌.RAPD分型结果显示分离株均为同一克隆.采集的15份环境和物品标本培养结果均为阴性,但采取积极的医院感染控制措施后至2012年8月未再出现类似病例.结论 奥默毕赤酵母菌引起的早产儿医院获得性败血症可在医院内传播,落实院内感染防控措施是关键；卡泊芬净治疗早产儿真菌血症是安全有效的.
目的 分析早產兒醫院穫得性奧默畢赤酵母菌敗血癥的臨床及分子生物學特點,以提高對該病的認識和治療水平.方法 迴顧性分析2010年7至11月溫州醫學院附屬育英兒童醫院新生兒重癥鑑護病房(NICU)6例奧默畢赤酵母菌敗血癥患兒的臨床和病原學資料；對分離株進行鑒定,用隨機引物多態性分析(RAPD)進行同源性分析；同時根據醫院感染流行病學特徵,對患兒週圍環境和物品進行採樣分析.結果 6例患兒分離齣奧默畢赤酵母菌前平均住院時間28 d；使用抗菌藥物時間為13～45 d;6例患兒均接受靜脈營養,其中4例接受機械通氣,5例接受中心靜脈置管.5例經卡泊芬淨治療15 ～30 d後痊愈,l例使用氟康唑30 d後痊愈.菌株經儀器鑒定和18 S rDNA序列測定確認為奧默畢赤酵母菌.RAPD分型結果顯示分離株均為同一剋隆.採集的15份環境和物品標本培養結果均為陰性,但採取積極的醫院感染控製措施後至2012年8月未再齣現類似病例.結論 奧默畢赤酵母菌引起的早產兒醫院穫得性敗血癥可在醫院內傳播,落實院內感染防控措施是關鍵；卡泊芬淨治療早產兒真菌血癥是安全有效的.
목적 분석조산인의원획득성오묵필적효모균패혈증적림상급분자생물학특점,이제고대해병적인식화치료수평.방법 회고성분석2010년7지11월온주의학원부속육영인동의원신생인중증감호병방(NICU)6례오묵필적효모균패혈증환인적림상화병원학자료；대분리주진행감정,용수궤인물다태성분석(RAPD)진행동원성분석；동시근거의원감염류행병학특정,대환인주위배경화물품진행채양분석.결과 6례환인분리출오묵필적효모균전평균주원시간28 d；사용항균약물시간위13～45 d;6례환인균접수정맥영양,기중4례접수궤계통기,5례접수중심정맥치관.5례경잡박분정치료15 ～30 d후전유,l례사용불강서30 d후전유.균주경의기감정화18 S rDNA서렬측정학인위오묵필적효모균.RAPD분형결과현시분리주균위동일극륭.채집적15빈배경화물품표본배양결과균위음성,단채취적겁적의원감염공제조시후지2012년8월미재출현유사병례.결론 오묵필적효모균인기적조산인의원획득성패혈증가재의원내전파,락실원내감염방공조시시관건；잡박분정치료조산인진균혈증시안전유효적.
Objective To analyze the clinical features of fungemia caused by Pichia ohmeri (P.ohmeri) in neonate intensive care unit and explore its molecular biological characteristics so as to improve its diagnosis and treatment level.Methods The clinical data of 6 infected infants were retrospectively analyzed.The strains obtained from them were identified and homological analysis was performed through randomly amplified polymorphic assay to explore the epidemiological characteristics of this nosocomial infection.Results Before the isolation of P.ohmeri,they received intravenous antibacterial therapy for 13-45 days.Among them,4 received mechanical ventilation and 5 had a peripheral insertion of central venous catheters.Five infants were healed after a therapy of caspofungin for 15-30 days.One neonate recurred after a 30-day administration of fluconazole.The strain was identificd and confirmed as P.ohmeri.RAPD genotyping results showed that all 6 strains were from the same clone.No similar cases occurred after positive control measures despite a negative epidemiological sampling.Conclusions P.ohmeri may cause premature infant fungemia and lead to its spread in hospital.Hospital infection control is a key point.And caspofungin is both safe and effective in the therapy of neonate fungemia.
