已发表论文

棘白菌素类药物与两性霉素 B 用于治疗患有嗜中性白血球低下症的成人血液病人的热带假丝酵母菌菌血症的比较:一项多中心回顾性队列研究

 

Authors You L, Yao C, Yang F, Yang Q, Lan J, Song X, Shen J, Sheng X, Chen X, Tang H, Jiang H, Wu H, Qian S, Meng H

Received 18 April 2020

Accepted for publication 25 June 2020

Published 10 July 2020 Volume 2020:13 Pages 2229—2235

DOI https://doi.org/10.2147/IDR.S258744

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Professor Suresh Antony

Background: Candida tropicalis  is the most common non-albicans Candida  species identified in immunocompromised patients, which often appears with high mortality. However, data on the outcomes of treatment for Candida tropicalis  fungemia in patients with neutropenia remain limited.
Methods: In the present study, 90 neutropenic adult patients with proven Candida tropicalis  fungemia, who received initial antifungal therapy, were retrospectively analyzed.
Results: These results revealed that the overall 8-day and 30-day mortality among patients in the entire data set were 22.2% and 33.3%, respectively. However, there was no significant difference between the survival and death group, in terms of baseline characteristics. The univariate analysis of risk factors identified the treatment with azole as a predictor of mortality, while treatments that containing amphotericin B were associated with reduced mortality. In addition, the survival rate on day 30 was observed in 60.7% (17/28) of patients who were initially treated with echinocandins, while this was observed in 86.4% (19/22, P= 0.039) and 100% (13/13, P= 0.024) of patients treated with amphotericin B plus echinocandins and amphotericin B, respectively.
Conclusion: These data indicate for the first time that the initial therapy with amphotericin B-based agents was associated with a better survival rate and could be assessed as the optimal strategy for the treatment of Candida tropicalis  fungemia in patients with neutropenia.
Keywords: Candida tropicalis , candidemia, hematological malignancy, neutropenia, amphotericin B, echinocandins




Figure 1 Comparison of clinical outcomes between different initial antifungal treatments...