真菌感染的现状与治疗进展课件

真菌感杂的现状与治疗进抗真菌的发展已经经历了一条崎岖的道路,达到了令人鼓舞的水平仅在20年前我们对霉菌和抗真菌还缺乏兴趣和了解。在此后不到十年中,AIDS病就将我们从婴儿尿布疹带入到成人的食道炎和鹅口疮。现在,医生对念珠菌、隐球菌病、组织胞浆菌病、球孢子菌病这些词不再陌生JohnR.TwentyYearsofridingtherocket:WhendowereachtheresentedFocusonFungalinfectionsII.2001,4.14-16.WashingtonD.CU.S.A.AbstractsP41-43°真菌作为重要的院内病原菌,尤其在ICU内急剧的发展,已经对危重病医学产生了重大的影响。近年,在ICU中非中性粒细胞减少的患者,真菌感染一直显著上升。PittetDarE.SolomkinJSWhentostartantifungaltherapyinthenon-neutropeniccriticallyill?In:Yearbookofintensivecareandemergencymedicine.NewYork:Sprenge1996:567-577真菌与霉菌的概即往真菌和霉菌为同一概念,且前统称真菌,霉菌是真菌的一种。真菌是院内染见微院内感染的—7.5%血液感染的第四位肿瘤病人发病率——为8%严重创伤、烧伤病人—高达16%病死率—达55%70%美国国立医院院内感染检(NNIS)1980-1990院内真菌感染增加2倍念珠菌属占C分离致病菌第生位外科病人—发生率增加最明显3027.9■孜!A6自再￠哲各麗面日哲院内感染的比例206"E￡能哲16.5血培养结果JarvisWR,MartoneWJ.PredominantpathogensinhospitalinfectionsJAntimicrobChemother.1991:28:15-19美国国立院内感染检测1980.1-1990.12·115家医院调查真菌感染的情况12%院内感染6.0%6%19801990Beck-SagueCMetal.NationalnosocomialinfectionsurveillancesystemSeculartrendsintheepidemiologyofnosocomialfungalinfectionintheUnitedStates.1980-1990.In:RexJH.Seriouscandidainfection:riskfactors,treatment,andprevention.selectedreadings:FocusonFluconazole.8NewYork:PfizerInc:1995:9-1518%Surgicalwound16%口Urinarytract14%口Bloodstreame90%10%58%1.50%9801990Beck-SagueCMetal.NationalnosocomialinfectionsurveillancesystemSeculartrendsintheepidemiologyofnosocomialfungalinfectionintheUnitedStates.1980-1990.In:RexJH.Seriouscandidainfection:riskfactors,treatment,andprevention.selectedreadings:FocusonFluconazole9NewYork:PfizerInc:1995:9-15charges124%可5Eoo05Increasedischarges9801990Beck-SagueCMetal.NationalnosocomialinfectionsurveillancesystemSeculartrendsintheepidemiologyofnosocomialfungalinfectionitheUnitedStates.1980-1990.In:RexJH.Seriouscandidainfection:riskfactors,