白血病患者口腔念珠菌病

O. Hamouda
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引用次数: 0

摘要

口腔念珠菌病是念珠菌属酵母菌过度生长引起的真菌病,对白血病患者来说是一个严重的问题。这种感染的死亡率由于真菌败血症而增加,与原发性口腔感染有关。目的:了解白血病患者口腔念珠菌病的患病率,鉴别口腔病变念珠菌属,并探讨影响其发展的因素。患者和方法:这是一项回顾性和描述性研究,从2016年11月7日到2017年3月2日,为期4个月,包括诊断为白血病的患者。收集并分析符合纳入标准的患者的社会人口学、临床和生物学资料。取病变标本,对沙伯氯霉素和沙伯氯霉素Actidionne进行直接检测和培养。通过成丝试验、碳水化合物发酵和同化对分离酵母进行鉴定。结果:56例患者纳入本研究。口腔念珠菌病检出率最高(48.21%),平均年龄33、86岁,以男性为主(64.28%)。念珠菌、白色念珠菌最多(55.55%),其次为念珠菌。裸露念珠菌(22.22%)、热带念珠菌(14.81%)和克鲁西念珠菌(7.40%)。主要影响因素为肠外营养(55,55%)、皮质类固醇治疗(55,55%)、抗生素治疗(37,03%)、中性粒细胞减少(25,92%)和糖尿病(11.11%)。结论:口腔念珠菌感染是白血病患者常见的并发症。白色念珠菌是主要病原,但其他念珠菌也有重要的参与。
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Oral Candidiasis in Leukemia Patients
Oral candidiasis are mycoses resulting from the overgrowth of yeasts of the Candida genus, represents a serious problem for patients with leukemia. The mortality rate of this infection has increased due to fungal septicemia, associated with a primary buccal infection. Objective: The aim of our study is to determine the prevalence of oral candidiasis in leukemia patients, identify the Candida spp. in buccal lesions, differentiate the factors that influence their development. Patients and Methods: This is a retrospective and descriptive study conducted over a four-months period from November 7, 2016 to March 2, 2017, including patients diagnosed with leukemia. Sociodemographic, clinical and biological data from patients fulfilling the inclusion criteria were collected and analyzed. The lesion sample was taken and studied by direct exam and culture on Sabouraud Chloramphenicol and Sabouraud Chloramphenicol Actidionne. The identification of the isolated yeast was done by the filamentation test, carbohydrate fermentation and assimilation.  Results: 56 patients were included in this study. Most of the cases (48,21%) were positive to oral candidiasis Their average age was 33,86 years, they were mainly made up of men (64.28%).  Candida, albicans was the most frequent species found (55,55%), followed by Candida. glabrata (22.22%), Candida tropicalis (14.81%) and Candida krusei (7,40%). The main contributing factor found was parenteral nutrition (55,55%), corticosteroid therapy (55,55%), antibiotherapy (37,03%), neutropenia (25,92%) and diabetes (11,11%). Conclusion: The results suggest that oral candidiasis is a frequent complication in the leukemia patients. C. albicans was the main etiological agent, however, there is an important participation of other Candida species.
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