[酵母引起的真菌病的预防]。

H P Seeliger
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引用次数: 0

摘要

霉菌和大量的空气孢子(分生孢子、节孢子等)以及具有兼性致病性的酵母菌广泛存在,使得预防由这些机会菌引起的人类感染相当困难。抑制这类真菌和持续监测濒危患者需要相当大的努力和成本。在念珠菌感染中,适当的控制尤其困难,因为在许多个体中,致病酵母菌可能被认为是粘膜的“正常”共生体。显性继发性感染通常是内源性的,因此由Gemeinhardt(1976)引入了“内生菌病”的名称。在特殊情况下,如护理大面积烧伤患者,或骨髓移植或全身照射后的患者,或关节手术后的患者,在有限的时间内,完全消除酵母菌与抗菌去污一样重要。在其他人群中,对白色念珠菌采取类似的激烈控制措施被认为是不必要的。将局部念珠菌细胞计数减少到低于个体耐受水平的数量可能被认为是足够的。然而,由于在婴儿和重症监护病房的许多病人中,特别是在恶性免疫细胞瘤和各种性质的白血病病例中,耐受性水平极低,因此通过适当的卫生措施进行预防并最终进行预防性抗真菌治疗是适当控制的组成部分。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Prevention of mycoses caused by yeasts].

The wide-spread ubiquitous occurrence of molds and great masses of aerial spores (conidia, arthrospores etc.) as well as of yeast species with facultative pathogenicity, renders prophylaxis of respective human infections caused by such opportunists, rather difficult. Suppression of such fungi and continuous surveillance of endangered patients require considerable efforts and costs. Adequate control is particularly cumbersome in Candida infections, since the causative yeasts may be considered as "normal" commensals of the mucous membranes in many individuals. Overt secondary infections are frequently of endogenous origin, hence the name "endomycoses" as introduced by Gemeinhardt (1976). Under particular conditions such as care for patients with extended burns, or patients after bone-marrow transplantation or irradiation of the whole body, or patients after joint surgery, the complete elimination of yeasts is just as essential as the antibacterial decontamination over a limited period of time. In other groups of individuals similar drastic measures of control against Candida albicans are not deemed necessary. Reduction of local Candida cell counts to amounts below the individual level of tolerance may be deemed sufficient. Since the level of tolerance is, however, extremely low in infants and in many patients of the intensive care wards, especially in cases of malignant immunocytomas and leukemias of various nature, prophylaxis by proper hygienic measures and eventual preventive antimycotic treatment is an integral part of proper control.

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