Author/Editor		Maček, M; Černelč, P; Mueller-Premru, M; Križan-Hergouth, V
Title		Ugotavljanje gliv v nadzornih kužninah pri bolnikih z akutno levkemijo
Translated title		Isolation of fungi from surveillance cultures in patients with acute leukaemia
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 64, št. 10
Publication year		1995
Volume		str. 581-5
Language		slo
Abstract		Background. Patients with acute leukaemia (AL) are, due to the severe neutropenia and immunodeficiency, that follow chemotherapy, predisposed to fungal infections. In order to prevent disseminated mycoses, the patients receive antifungal prophylaxis. In the period of neutropenia we regularly control patients' surveillance cultures for fungi and evaluate sensitivity of fungi for antifungal drugs. Methods. The spectra of fungal species from surveillance cultures among 60 cycles of chemotherapy in 34 patients (20m, 14f) with AL in age 23-74 years were analysed. All patients were treated in Haematology Department in Ljubljana from 1993 to 1995. We searched for fungi in patients' pharynx, nose, sputum and stool once a week, before antifungal prophylaxis, during prophylaxis with ketoconazole or fluconazole and during treatment with amfotericin B. Results. We isolated fungi from pharynx in 40 precent before antifungal prophylaxis, in 32,4 precent durign prophylaxis with ketoconazole, in 25 precent during prophylaxis with fluconazole and in 41,7-46,2 precent during treatment with amfotericin B. Comparing to the state before antifungal prophylaxis reduced fungal colonization in nose was achieved after reatment with amfotericin B that lasted more than two weeks and a slighty reduced fungal colonization in period of prophylaxis with gluconazole. On the contrary, during prophylaxis with ketoconazole and during 1 week treatment with amfotericin B, there was no reduction of fungal colonization in nose. In spite of the prophylaxis with ketoconazole or fluconazole and treatment with amfotericin B, we isolated fungi from sputum and stool more often than before antifungal prophylaxis. The yeast Canadida albicans was isolated from all surveillance cultures, before antifungal prophylaxis, during prophylaxis with ketoconazole or fluconazole, and during treatment with amfotericin B most frequently.(trunc.)
Summary		Izhodišča. Bolniki z akutno levkemijo (AL) zaradi pomanjkljivega imunskega odziva in hude nevtropenije po citostatičnem zdravljenju pogosteje zbolevajo zaradi okužb z glivami. Da bi preprečili nastanek razširjene okužbe z glivami, katere zdravljenje je pogosto neuspešno, bolniki profilaktično prejemajo protiglivna zdravila. V obdobju nevtropenije po citostatičnem zdravljenju pri bolnikih z AL vedno ugotavljamo glive v nadzornih kužninah in določamo njihovo občutljivost na protiglivna zdravila. Metode. preučili smo pojavljanje gliv v nadzornih kužninah med 60 krogi citostatičnega zdravljenja pri 34 bolnikih (20m, 14ž) v starosti 23-74 let, ki so se zdravili na Hematološki kliniki v Ljubljani v letih 1993-1995. Prisotnost gliv smo ugotavljali enkrat tedensko na sluznici žrela in nosu, v izpljunku in v blatu pred začetkom prifilakse s ketokonazolom ali flukonazolom, med profilakso in med zdravljenjem z amfotericinom B. Rezultati. pred profilakso smo osamili glive v 40 odstotkih med profilakso s flukonazolom v 25 odstotki, med zdravljenjem z amfotericinom B pa v 41,7-46,2 odstotki brisov žrela. na nosni sluznici je bilo po več kot dvotedenskem zdravljenju z amfotericinom B kolonizacija z glivami manjša kot pred profilakso, medtem ko je bila med profilakso s flukonazolom nakazano manjša, med profilakso s ketokonazolom in po enotedenskem zdravljenju z amfotericiranom B pa nismo dosegli manjše kolonizacije. V izpljunkih in v blatu so se, kljub profilaksi s ketokonazolom kot tudi flukonazolom in zdravljenju z amfotericinom B, glive pojavljale pogosteje kot pred profilakso. Najpogos teje smo iz nadzornih kužnin pred in med profilakso s ketonazolom ali flukanazolom ter med zdravljenjem z amfotericinom B osamili glivo Candida albicans.(krajš.)
Descriptors		LEUKEMIA NEUTROPENIA FUNGI ANTIFUNGAL AGENTS MYCOSES