异基因造血干细胞移植后发生真菌性败血症的临床分析

目的 总结异基因造血干细胞移植后发生真菌性败血症的临床特点及治疗方法,提高诊治水平.方法 回顾性研究2009年1月-2011年4月北京军区总医院血液科行异基因造血干细胞移植后140例患者的临床资料.结果 共有8例发生真菌性败血症感染,发生率为5.7％,检出的真菌均为假丝酵母菌属,其中白色假丝酵母菌5株、光滑假丝酵母菌2株和热带假丝酵母菌1株;选用敏感抗真菌药物治疗后5例获得治愈,3例治疗无效死亡.结论 异基因造血干细胞移植后真菌性败血症病原菌以假丝酵母菌属为主,死亡率较高,应二级预防性和早期经验性抗真菌治疗,减少真菌败血症的发生.

Clinical analysis of fungal septicemia after allogeneic hematopoietic stem cell transplantation

OBJECTIVE To improve the diagnosis and management of fungal sepsis after allogeneic hematopoietic stem cell transplantation by studying the clinical features and treatment methods.METHODS Retrospective study was performed on 140 patients who received allogeneic hematopoietic stem cell transplantation in department of hematology,General Hospital of the Beijing Military Commanding Region from Jan.2009 to Apr.2011.RESULTS Fungal sepsis infections occurred in 8 cases with the incidence of 5.7%;all of the pathogens isolated were Candida,including 5 strains of C.albicans,2 strains of C.glabrata,and 1 strain of C.tropicalis;5 patients were cured after the treatment with antifungal agents,and 3 patients died due to ineffective treatment.CONCLUSION Candida are the predominant pathogens causing fungal septicemia infections after allogeneic hematopoietic stem cell transplantation.The mortality rate is relatively high,and secondary prevention and empirical antifungal therapy should be administered at early stage to reduce the incidence of fungal septicemia.