640例儿童真菌感染的特征及耐药性分析  

Analysis of feature and drug resistance of child fungal infection in 640 cases

作　　者：彭雪松[1] 刘岚[1] 

机构地区：[1]重庆医科大学附属儿童医院,重庆400014

出　　处：《现代医药卫生》2009年第22期3365-3367,共3页Journal of Modern Medicine & Health

摘　　要：目的:探讨患儿真菌感染的临床特点、危险因素及耐药性监测。方法:回顾性分析640例真菌培养阳性患儿的临床资料。结果:640例中菌种以白色念珠菌为主,占65%,近平滑念珠菌感染有上升趋势,占14.3%,感染部位以呼吸道及消化道为主。640株真菌耐药的药敏结果提示白色念珠菌对两性霉素B和5-氟胞嘧啶敏感,对唑类药物耐药率在80%以上。近平滑念珠菌对整体抗真菌药物的耐药率低于其他念珠菌属。血液科及ICU中抗生素联合应用,住院天数≥7天,年龄≤3岁均是真菌感染的危险因素,其中年龄≤3岁真菌感染的相对RR值是年龄>3岁的11.1倍。真菌药敏结果提示对氟康唑耐药,但临床使用氟康唑仍有效。结论:在患儿真菌感染中,以白色念珠菌为主,感染部位以呼吸道及肠道为主。年龄、使用免疫抑制剂、联合应用抗生素可作为真菌感染的独立危险因素。Objective：To discuslye clinical feature of the fungal infection in children,its risk factors and the monitor of the drug resistance.Methods：To Retrospective analyse six hundred and forty children s clinical data with positive fungal culture,and divide them into three groups.The infection feature,risk factors and the feature of the drug resistance were compared retrospectively according to their clinical data with statistics.Results：Candida albicans（65%） was the common pathogenic fungus among the 640 fungal strains. Candida parapsilosis infection had the trend of escalation （14.3%）,which was higher than other reports obviously.Respiratory and digestive tract were the most common infectious sites.The drug-resistant rate of C. albicans to 5-fluoroeytosine amphoteriein B and azoles was 1.9%, 1.7% and 〉80% respectively. C. parapsilosis had the most sensitive to all antibiotics. The combined use of antibiotic in blood department and ICU,length of hospital stay ≥ 7 d,age≤3 years were risk factors for fungal infections. The fungal infections RR value in the age of ≤ 3-year-old was 11.1 times of that in the age ≥3-year-old. Conclusion： Candida albieans is the mainly nosophyte of the children＇s fungal infection,the infection positions are respiratory tract and alimentary tract. Age,using immunodepressant,using antibiotics combination are the independent risk factors of the fungal infection.

关 键 词：患儿 真菌感染 耐药 危险因素 

分 类 号：R72[医药卫生—儿科]