天疱疮和大疱性类天疱疮患者口腔念珠菌感染的调查研究

随着医学界对天疱疮和大疱性类天疱疮认识的不断深入,这两种疾病的患者生存期延长,但是广泛应用糖皮质激素和免疫抑制剂,真菌感染的发病率逐渐增加,特别是口腔念珠菌感染为其中一种最常见的感染。本文对2003年6月~2006年6月期间,沈阳市第七人民医院皮肤科住院的87例天疱疮和133例大疱性类天疱疮患者进行口腔念珠菌检查、随访,旨在了解天疱疮和大疱性类天疱疮患者口腔念珠菌感染的现状及其规律。现将结果报告如下:1资料和方法1.1临床资料87例天疱疮和133例大疱性类天疱疮患者均为沈阳市第七人民医院皮肤科确诊并接受治疗的患者。其中男106例,…     

创伤患者伤口感染的危险因素分析

目的 :了解创伤患者伤口感染发生的危险因素。方法 :对我院 1999年～ 2 0 0 1年间 5 2 0例外伤患者进行回顾性调查 ,并对伤口分泌物进行细菌学检查及耐药性分析。结果 :5 2 0例中感染率 14 .0 3% ,感染的病原菌以革兰阳性杆菌为主 (72 .6 % ) ,其次是革兰阳性球菌 (17.8% )和念珠菌 (9.6 % )。在革兰阴性杆菌中 ,大肠埃希菌占主导 (34% ) ,革兰阴性球菌中 ,主要是凝固酶阴性的葡萄球菌 (76 .9% )。这些细菌对抗生素均存在不同的耐药性 ,并有多重耐药的趋势 ; 类伤口感染率 5 6 .9%明显高于 类伤口的感染率7.7% (P<0 .0 5 )。结论 :创伤患者易发生伤口感染 ,特别是重伤及伤口状况差的患者 ,有高的易感性。针对创伤患者应采取相应措施 ,降低感染发生率。     

口腔念珠菌病患者念珠菌分离株的菌种分布及流行趋势分析

目的回顾性分析我院近5年口腔黏膜科念珠菌病患者的念珠菌分布及流行趋势。方法对2015年至2019年到北京大学口腔医院黏膜科就诊的27 162例患者的唾液培养样本结果进行回顾性分析。将所有结果录入Excel表格后按照菌种、菌量、患者性别、患者年龄进行分组分析。结果在2015至2019年分离自口腔念珠菌病患者的所有念珠菌菌株中,白念珠菌所占的比例最高,热带念珠菌和其他念珠菌的阳性比例呈现逐年上升趋势。在白念珠菌、热带念珠菌、光滑念珠菌感染的样本中均以菌落数≥200 CFU/mL的菌株为主,而克柔念珠菌、其他念珠菌菌落数≥200 CFU/mL的菌株比例低于白念珠菌、热带念珠菌和光滑念珠菌,而菌落数≤30 CFU/mL的菌株比例明显高于白念珠菌、热带念珠菌和光滑念珠菌。统计分析结果显示,女性患者占比明显高于男性患者(P0.05)。口腔念珠菌各年龄段的占比总体随年龄的增长呈现升高趋势,且在41～50岁年龄段及其后升高明显。结论虽然白念珠菌感染仍然是口腔念珠菌感染的主要病原菌,但热带念珠菌和其他念珠菌的阳性比例近年来呈现逐年上升趋势。口腔念珠菌病患者菌株分布和流行趋势分析对于临床用药策略有指导意义。     

52例HIV／AIDS患者口腔念珠菌病的临床表型及病原学鉴定

目的：口腔念珠菌病（ oral candidiasis,OC）是HIV／AIDS患者中最常见的口腔疾病,研究其临床表型及病原学特点对AIDS相关性口腔念珠菌病的诊断和临床用药有重要的指导意义。方法将70例确诊为HIV／AIDS且初步诊断为AIDS相关性口腔念珠菌病患者使用棉拭子在其病损区取材,接种至科玛嘉念珠菌显色培养基检验。结果 HIV／AIDS患者念珠菌感染的病例为52例,临床表型以假膜型和红斑型为主,其中假膜型最为常见（56％）。 HIV／AIDS患者口腔念珠菌病各致病病原菌以白念珠菌的检出率最高（60．32％）,热带念珠菌次之（19．05％）,光滑念珠菌为（12．70％）,克柔念珠菌（7．94％）。有9例HIV／AIDS伴口腔念珠菌病患者,检测出病原菌的混合感染,其中2例为3种病原菌感染。结论 HIV／AIDS患者口腔念珠菌病临床表型复杂且可以伴发,单纯通过临床表现鉴别诊断常不准确,且病原菌的准确分型可以指导临床用药,降低耐药菌的产生。     

慢性阻塞性肺疾病并念珠菌性口炎患者病原学及危险因素分析

目的 探讨入院慢性阻塞性肺疾病(COPD)并念珠菌性口炎患者的病原学特征以及相关危险因素.方法 采用病例研究,对2007年4月1日至2011年1月31日入院的82例COPD并念珠菌性口炎患者和82例无念珠菌性口炎COPD患者进行匹配,应用SPSS 17.0统计软件行条件logistic回归模型分析COPD患者念珠菌性口炎发生的危险因素.结果 (1)从念珠菌性口炎患者假膜培养共分离出念珠菌83株,以白念珠菌(90.4％)为最多,其次为光滑念珠菌(3.6％)、克柔念珠菌(2.4％)、热带念珠菌(2.4％)、近平滑念珠菌(1.2％);(2)统计学分析结果显示全身应用、吸入糖皮质激素是入院患者口腔念珠菌感染的独立危险因素.结论 白色念珠菌是COPD患者口腔部念珠菌感染的主要病原菌,规范使用全身糖皮质激素、正确吸入糖皮质激素是预防COPD患者口腔念珠菌感染的关键.     

成人口腔黏膜念珠菌病的多因素分析

为探讨影响成人口腔黏膜念珠菌病发生的因素,选取口腔黏膜念珠菌病、复发性阿弗他溃疡、扁平苔藓、舍格伦综合征、白斑、天疱疮、类天疱疮患者及口腔黏膜健康者为研究对象,详细记录731个样本的年龄、性别、吸烟、口腔卫生情况、抗生素使用、义齿、口腔黏膜疾病、全身疾病,对结果进行多元Logistic回归分析,得到影响口腔黏膜念珠菌病发生的因素有4类,分别为发病前使用抗生素、口腔卫生情况、口腔黏膜疾病、全身疾病,即多种因素的作用导致口腔黏膜念珠菌病的发生。     

白色念珠菌胃癌株对细胞粘附作用的研究

研究白色念珠菌 (candidaalbicans)正常人口腔株与胃癌株对口腔粘膜细胞及肺上皮细胞的粘附性能。将白色念珠菌与正常人口腔颊粘膜细胞或培养的人肺上皮细胞于 37℃温育一定时间后 ,计算每个细胞粘附白色念珠菌数。白色念珠菌胃癌株对两类细胞粘附能力均较正常人口腔株强 ,其差异有显著性 (p <0 .0 1)。粘附性是致病菌侵袭力的重要机制 ,粘附性增强是白色念珠菌由正常微生物群成员转变为条件致病菌的重要条件。     

非白色念珠菌是肿瘤患者感染的重要病原菌

近４０年来,在１５９１例肿瘤患者全身性念珠菌感染中,由非白色念珠菌引起的感染占４６％,其中热带念珠菌占２５％,光滑念珠菌占８％,近平滑念珠菌占７％,克柔念珠菌占４％,其他种〈１％。本文叙述了念珠菌属各个种的病原性及对肿瘤与非肿瘤患者的易感染和有关因素。文中最后强调,大多数念 珠菌病由内源性引起,但外源性或医源性暴发并不少见。     

白念珠菌糖代谢与毒力

正白念珠菌是人体内最常见的病原菌和共生真菌。白念珠菌作为一种正常菌群时,存在于人体的肠道、口腔、皮肤和70%的健康女性生殖道内。在免疫力正常的人群中,白念珠菌主要引起浅表感染。然而,免疫力异常人群如艾滋病、移植术后、糖尿病和较长时期服用抗生素等患者等可发生深部念珠菌感染[1]。每年全球范围内约有35～40万的念珠菌血症患者发展为致命性感染,死亡率高达     

膀胱造瘘术后尿道念珠菌感染1例

白念珠菌是临床上最常见的病原真菌,常引起黏膜、皮肤的感染如念珠菌性龟头包皮炎、口腔黏膜念珠菌感染,以及深部的侵袭性念珠菌感染如念珠菌血症等,由白念珠菌感染引起的尿道炎并不常见。我们在工作中遇到1例实施膀胱造瘘术后发生的尿道念珠菌感染,现报告如下。1病例资料男性,54岁,因"尿道分泌物并疼痛1个月余",于2010年4月26日就诊于我科。查体:体温     

海南岛4市县人群口腔假丝酵母菌分布情况的初步调查

目的：调查海南岛海口、三亚市、五指山市和保亭县四市县人群口腔假丝酵母菌的分布情况,为口腔假丝酵母菌分子生物学和遗传学特点研究提供基础资料。方法：分离出的假丝酵母菌经过菌落特征、制片乳酸酚棉蓝染色、芽管形成试验、厚膜孢子形成试验等初步鉴定,并用科玛嘉显色培养基培养确定。结果：海口、三亚市、五指山市和保亭县人群口腔假丝酵母菌总分离率为25．23％．其中白假丝酵母菌占54．48％,光滑假丝酵母菌占14．04％,热带假丝酵母菌占11．06％,克柔假丝酵母菌占9．36％。住院病人和健康人口腔假丝酵母菌的分离率分别为39．95％和11．61％,差异有统计学意义（P〈0．01）,结论：海南地区人群口腔假丝酵母菌的总分离率高于国内其它省份,分离出的假丝酵母菌以白假丝酵母菌为首位,病人口腔假丝酵母菌分离率明显高于健康人。     

Growth of the fungal pathogen Candida in parotid saliva of patients with burning mouth syndrome

Subclinical Candida infection has been suggested as one of the aetiological factors in patients with burning mouth syndrome (BMS). In order to investigate the possible factors which contribute to the relatively high isolation rate of Candida in BMS, parotid saliva samples (20 in toto) from patients with this condition were collected and the growth of Candida in each sample dynamically observed using a computerized turbidometric assay system. A total of thirteen parotid saliva samples obtained from healthy individuals served as normal controls. The results showed no significant growth differential within the test and control saliva samples, when a single isolate each of Candida albicans and Candida tropicalis were cultured for 24 h, at 37 degrees C. A single isolate of Candida glabrata tended to grow better in the saliva from BMS patients than the controls. These results indicate that the composition of saliva may be a contributory factor for the high isolation rate of Candida in saliva of BMS patients.     

Resistogram typing of Candida albicans isolates from oral and cutaneous sites in irradiated patients

Thirteen resistogram strains of Candida albicans were found among isolates obtained from the mouth and cutaneous sites of irradiation of 27 patients receiving treatment for oral and laryngeal cancer. In all cases the yeast was recovered from the mouth before treatment, but not from the skin site until after treatment had begun. Of the 27 patients, 25 harboured one or more strains with identical resistograms in both sites.     

Candida albicans: Frequency and characterization in oral cancer (Stage I) from smokers and drinkers

The frequency and the biotype of Candida albicans, from patients with epidermoid carcinoma of the oral mucosa (stage I) were evaluated. The patients chosen were habitual drinkers and smokers, aged 34 to 81 years who had not submitted previously to any treatment. They exhibited ulcero-vegetative lesions, mainly on the floor of the mouth, palate and tongue and were classified as stage TNM 100 - TNM 200. Samples from the buccal mucosa were collected for mycological study including: identification of yeasts, serotyping, determination of exo-enzymes as proteinase and phospholipase as well as "killer" assay for biotype characterization. Positive cultives for yeasts were observed in 51.5% of the patients(17/33), being 21.2% represented by C. albicans, all serotype A. The "killer" test demonstrated two different biotypes of C. albicans, namely 211(71.4%) and 611(28.6%), with high levels of proteinase (Prz < 0.30), while phospholipase presented intermediary levels (Pz > 0.29 and =/< 0.69). These data suggested a potentiality to virulence of C. albicans, although did not show an association of a particular biotype with the carcinogenic factors present or with the development of oral epidermoid carcinoma in this initial stage.     

The presence of bacteria and yeast like fungi in specimens from surgical patients

The aim of this study was to determine the incidence of Candida spp. strains in specimens obtained from surgically treated patients as well as to analyze the accompanying bacterial flora, both aerobic and anaerobic. The material came from two groups of patients. In the first group consisting of patients operated for colon and rectum carcinoma, the samples included peritoneal fluid, colon or rectum bioptates, pus, blood, and wound swabs. In the other group, biopsy material and smears from post operation wounds were taken from patients who underwent a surgical treatment of larynx carcinoma. Altogether, 282 various clinical specimens from 165 patients were analysed, and 41 Candida spp. strains were isolated: 39 strains of C. albicans and 2 strains of C. tropicalis. In 20 out of 41 specimens infected with Candida spp. (48.8%) the co-infection with bacterial aerobic flora was found. In 10 cases (24.4%), the fungi were isolated together with aerobic and anaerobic bacterial flora, whereas in 2 specimens (4.9%) the anaerobes and Candida albicans were diagnosed. The remaining 9 samples showed only the presence of Candida spp. (21.9%). From among aerobic bacterial flora Enterococcus spp. strains (n = 17) and Gram negative rods from Enterobacteriaceae family (n = 13) were the most frequently isolated. The bacterial strains of Streptococcus spp. (n = 5), Pseudomonas spp. (n = 3), Staphylococcus spp. and Corynebacterium spp. (2 strains, both) were identified more rarely. Bacteroides spp. were the most frequent members of bacterial anaerobic flora (n = 10). Other isolated anaerobic bacteria were classified as Fusobacterium spp. or Peptostreptococcus spp. (1 strain each). E. coli and Enterococcus spp. strains of aerobic bacterial flora were more frequently isolated together with Candida spp. CONCLUSIONS: (i) Mixed bacterial flora was found to predominate in the clinical material from the patients after surgery. (ii) Candida spp. were most frequently found together with aerobic bacterial flora.     

Prevalence of Candida albicans in patients receiving total parenteral nutrition

The prevalence of Candida albicans was quantitatively compared in 74 surgical patients during and after total parenteral nutrition (TPN). Suppression of oral food intake is probably responsible for the decrease of the C. albicans population in the mouth. On the contrary anal swabs were more often positive for C. albicans during TPN. This may be due to local conditions as was observed in a group of patients who were not given TPN but were also immobilized for a long period.     

Effectiveness of different cleaning agents on the adherence of Candida albicans to acrylic denture base resin

doi: 10.1111/j.1741‐2358.2010.00379.x
Effectiveness of different cleaning agents on the adherence of Candida albicans to acrylic denture base resin Objective:  To evaluate the ability of three alkaline peroxide‐type (Polident, Efferdent, Fittydent) and two mouth rinse cleaning agents (CloSYSII and Corsodyl) to inhibit Candida albicans on acrylic denture base resin. Background:  Appropriate routine cleaning of dentures is necessary to prevent denture stomatitis and maintenance of healthy supporting tissues. Materials and methods:  A total of 180 acrylic resin specimens (10 × 10 × 2 mm) were prepared and divided into six groups. Candida albicans was incubated on Sabouraud dextrose agar (SDA) at 37°C for 48 h. After dilution, a final yeast suspension of approximately 10 6 C. albicans per millimetre was prepared. Ten acrylic resin specimens for each group were placed in a sterile Petri dish covered with 20 ml of fungal suspension and incubated at 37°C for 90 min. Then, the specimens were immersed in 40 ml of the test solution at 37°C for 15, 30 and 60 min. Fungal cells adhering to acrylic resin surfaces were fixed in formaldehyde and counted microscopically. Results:  Mouth rinses showed the highest removal activity for all the treatment times and completely eliminated the adherence of C. albicans. Conclusions:  The use of mouth rinse may be a suitable method for cleaning dentures.     

Evaluation of the clinical efficacy of a mouthwash and oral gel containing the antimicrobial proteins lactoperoxidase, lysozyme and lactoferrin in elderly patients with dry mouth--a pilot study

Objectives: To evaluate the clinical efficacy of a mouthwash and oral gel containing the antimicrobial proteins lactoperoxidase, lactoferrin and lysozyme, in a sample of elderly individuals with dry mouth. Material and methods: Twenty elderly institutionalised subjects with dry mouth and with a certain degree of independence for daily life activities were included in this pilot study. A randomised, double blind and cross‐over design was used. The study variables comprised subjective dry mouth sensation, the severity of discomfort assessed by means of a visual analogical scale (VAS), the Oral Health Impact Profile (OHIP), the presence of signs and symptoms of dry mouth, sialometry and Candida albicans culture. All the variables were recorded before and after each of the two periods of the study. Results: The 20 selected subjects we made up of 16 women and four men, with a mean age of 81.3 years. Improvement was observed on analysing the data between the first and second intervention period in terms of the OHIP values, the presence of dry mouth, and the need to drink fluids to swallow. However, the improvement in certain variables before and after treatment did not take a positive course in all cases, and some subjects even improved with placebo. Conclusions: The evaluated mouthwash and oral gel improved some subjective and clinical aspects in elderly individuals with dry mouth, though a placebo effect cannot be entirely discarded.