334株临床假丝酵母菌的菌种分布及耐药性分析  

Distribution and Resistance of 334 Strains of Candida

作　　者：杨自副 黄东[2] 

机构地区：[1]楚雄州中医院检验科,云南楚雄675000 [2]昆明医学院第一附属医院检验科,云南昆明650031

出　　处：《昆明医学院学报》2010年第3期109-113,共5页Journal of Kunming Medical College

摘　　要：目的调查分析分离酵母菌的种群分布与耐药情况,为合理使用抗真菌药物提供依据.方法采取回顾性分析的方法,对楚雄州中医院2008年1月至2009年9月临床标本分离到的334株假丝酵母菌用Whonet 5.4软件进行菌群、菌种分布和耐药性分析.结果在检出的498株假丝酵母菌中,有临床意义的334株,下呼吸道标本分离出136株(占40.7%),生殖道分泌物分离88株(占26.3%),尿液标本分离出75株(占22.5%),居临床送检标本的前三位,其中自有临床确诊意义的标本(生殖道分泌物、尿液、血液、伤口分泌物、脑脊液、深静脉导管及腹水)中分离出酵母样真菌198株(占59.3%),以白假丝酵母菌161株(48.2%),光滑假丝酵母菌96株(28.7%),热带假丝酵母菌35株(10.5%)为主;334株假丝酵母菌对两性霉素B、5-氟胞嘧啶、伏立康唑、氟康唑和伊曲康唑5种抗真菌药物耐药率分别为1.5%、4.8%、6.0%、10.8%、27.8%.结论假丝酵母菌临床分离菌株主要来源于下呼吸道、生殖道和尿液,且主要分布在内科、ICU、外科和妇科患者;假丝酵母菌感染在我院感染性疾病中的比例有上升趋势,特别是光滑假丝酵母菌和热带假丝酵母菌引起的感染有上升的趋势;5种常见抗真菌药物的耐药率为1.5%～27.8%不等,应加强对临床假丝酵母菌的药敏监测,提高治疗成功率.Objectives To study the distribution and the resistance of candida,and provide the evidence for rational drug administration.Method 334 clincal sample isolates of candida were analyzed by Whonet 5.4 software with retrospective studies.Results Of all 334 clinical isolates, 136 from lower respiratory tract sample,88 from genital tract secretion and 75 from urine sample.The above sample types listed the top three of clinical specimens. The isolate rates were 40.7%,26.3% and 22.5% respectively.The strain number of Candida albicans,Candida glabrata and Candida tropicalis was 161 （48.2%）,96 （28.7%） and 35 （10.5%）,In this 334 strains,198 strains （59.3%） were found with clinical significance,the main type was Candida albicans （48.2%）,Candida glabrata （28.7%） and Candida tropicalis （10.5%） respectively. The resistant rate of 334 isolates to Amphotericin B,5- Flucytosine,Voriconazole,Fluconazole and Itraconazole was 1.5%, 4.8%,6.0%, 10.8% and 27.8%,respectively.Conclusion Candida isolates in our hospital are mainly isolated from lower respiratory tract,genital tract secretion and urine.Candida infection has a rising tendency in our hospital. Candida albicans, Candida glabrata and Candida tropicalis are the mainly isolates of Candida infection.We should treat the infection of Candida according to the results of antifungal susceptibility testing.

关 键 词：假丝酵母菌 菌群 菌种 分布 耐药性 

分 类 号：Q939.11[生物学—微生物学]