念珠菌医院感染的危险因素与耐药性分析  

Analysis of the risk factors and resistance of candida infection in hospitals

作　　者：李整社 常迺萍[2] 白小刚 

机构地区：[1]陕西省西安市中医医院检验科,710001 [2]陕西省西安市儿童医院检验科,710001

出　　处：《检验医学与临床》2010年第6期500-501,共2页Laboratory Medicine and Clinic

摘　　要：目的探索念珠菌医院感染的危险因素及耐药性分析。方法住院患者各类感染标本中分离出的221株念珠菌,用法国梅里埃生物公司ATB-Expression细菌鉴定分析仪进行念珠菌鉴定及药敏分析。结果白色念珠菌检出率最高(57.0%),其次为热带念珠菌(19.4%)、光滑念珠菌(12.6%)。与医院感染念珠菌高度相关的危险因素为:基础疾病、静脉高营养疗法、长期住院患者、广谱抗生素长疗程、年龄老化、导尿及导尿管置留、糖皮质激素治疗等。念珠菌对5-氟胞嘧啶(5-FC)、两性霉类B(AMB)、氟康唑(FCA)、伊曲康唑(ITR)、伏立康唑(VRC)等5种抗真菌药物的敏感率分别为91.4%,94.6%,93.7%,71.9%和98.2%。结论医院感染念珠菌与一些医源性因素密切相关,应引起高度重视。念珠菌感染株有一定的耐药性,应加强念珠菌耐药性监测,以指导临床合理、有效地使用抗真菌药物。Objective To explore the risk factors and analyze the resistance of candida infection in hospitals.Methods 221 strains of isolated Candida from various types of specimens of infected patients,whom were treated with the Bio-Merieux of French ATB-Expression of bacterial sensitivity analyzer to identify the Candida and analyze the drug susceptibility.Results The highest detection rate is Candida albicans（57.0%）,followed by Candida tropicalis（19.4%） and sleek Candida（12.6%）.The risk factors of Candida infection within hospital is related with the basis of disease,intravenous high nutrition therapy,long-term hospitalized patients,long course of broad-spectrum antibiotic,aging,catheterization,the lingered catheter,glucocorticoid treatment and so on.The rate of sensitive of Candida to 5-fluorocytosine（5-FC）,mycophenolate gender category B（AMB）,fluconazole（FCA）,itraconazole（ITR）,voriconazole（VRC） is 91.4%,94.6%,93.7%,71.9% and 98.2% respectively.Conclusion Hospital infection with candida is closely related with iatrogenic factors,to which a great attention should be paid.As the strains of candida infection have a certain degree of resistance,therefore,the monitoring of candida drug resistance should be strengthened to guide the clinical rational and effective use of antifungal agents.

关 键 词：念珠菌 危险因素 抗真菌药物 耐药性 

分 类 号：R378.993[医药卫生—病原生物学] R969.4[医药卫生—基础医学]