76例医院内下呼吸道真菌感染的危险因素与耐药现状分析  

Risk Factors and Antibiotic Resistance of Lower Respiratory Tract(LRT) Fungal Infection in 76 Hospitalized Patients

作　　者：林云[1] 林平[2] 林君[1] 

机构地区：[1]台州医院呼吸内科,浙江临海317000 [2]台州学院医学院检验系,浙江台州318000

出　　处：《中华医院感染学杂志》2009年第5期510-513,共4页Chinese Journal of Nosocomiology

摘　　要：目的分析医院内下呼吸道真菌感染的主要相关因素、菌种分布及对常用抗真菌药物的敏感性,为其早期诊断和有效治疗提供依据。方法对台州医院呼吸内科2004年1月-2006年12月76例住院患者发生下呼吸道真菌感染进行回顾性分析。结果3年间发生医院内真菌感染共76例;分离到真菌77株;药敏结果显示,酮康唑、咪康唑耐药率普遍都较高,分别为50.6%、48.1%;相对伊曲康唑耐药性较低,为29.9%;医院内下呼吸道真菌感染的发生与基础疾病相关外,尚与年龄、长期住院、广谱抗菌药物使用欠规范、侵入性诊疗操作等密切相关。结论真菌的耐药菌株日趋增多,特别是唑类抗真菌药物已明显耐药,采用有效的防治措施刻不容缓。OBJECTIVE To explore the main risk factors of fungal infection in lower respiratory tract （LRT） of hospital patients, strains distribution and sensitivity to common antifungal agents so as to provide basis for earlier diagnosis and effective treatment. METHODS Retrospective analysis was taken of the 76 cases with fungal infection in LRT in patients of Taizhou Hospital from Jul 2004 to Jun 2006 based on the diagnostic criteria for nosocomial infections by Ministry of Health of PRC and also following the definition given by European Organization for Research on Treatment of Cancer （EORTC） and us Mycosis study Groap （MSG） in 2002. RESULTS Of the 76 cases, 84.2% were over 60 years old. All of them had underlying diseases, sixty cases had been repeatedly treated with 2 or 5 antibiotics before fungal infection; 21 cases received glucoeorticoid; 6 cases had chemol and radiotherapy and 21 cases underwent invasive treatment procedures. In the three years, 77 strains of fungi were isolated from all kinds of samples. Susceptibility testing indicated that the resistance to ketoconazole and miconazole was higher compared with that to fluconacole and itraconazole. CONCLUSIONS Fungal infection in LRT of hospital patients is closely related with age, long stay in hospital, wide administration of broad-spectrum antibiotics, immuno-suppressants and cytotoxic drugs. The most common fungi are Aspergillus and Mucor. There is an increasing number of strains of fungi resistant to drugs, especially to azole antifungal agents. Effective counter measures should be taken without delay. Antibiotic resistance analysis

关 键 词：真菌 下呼吸道 医院感染 危险因素 耐药分析 

分 类 号：R181.32[医药卫生—流行病学]