医院深部真菌感染900例病原菌分布及耐药性监测  

Pathogen Distribution of 900 Cases of Hospital Deep Fungal Infection and Antibiotic Resistance Monitoring

作　　者：李华信[1] 高春芳[1] 李晓冰[1] 马晓红 王丽 薛党党 孟晓东[1] 蒋欢欢[1] 王梦林[1] 

机构地区：[1]解放军第150中心医院检验科,河南洛阳471031 [2]解放军第522医院检验科,河南洛阳471031

出　　处：《中华医院感染学杂志》2010年第13期1980-1983,共4页Chinese Journal of Nosocomiology

摘　　要：目的探讨住院患者深部真菌感染状况,分析病原菌的感染类型,监测常用抗真菌药物的敏感性,为临床治疗深部真菌感染提供参考依据。方法采集2009年1-12月医院住院患者感染的深部临床标本6025份进行常规真菌培养,分离纯菌落接种到细菌测定系统随机体外诊断试剂板条上,应用细菌测定分析软件进行菌种鉴定及药敏试验。结果共发生医院深部真菌感染900例,>60岁老年患者685例,占76.1%;感染真菌标本以痰液检出率最高为54.8%,其次为尿液占13.4%;900株真菌中假丝酵母菌属感染最高占94.9%,其次为曲霉菌属、毛霉菌属和新型隐球酵母菌分别为2.1%、1.6%和1.4%;在真菌感染的假丝酵母菌属中以白色假丝酵母菌最多为470株,占52.2%;新型隐球酵母菌和皱褶假丝酵母菌的耐药率最低,分别为6.8%和9.1%;毛霉菌属的耐药率最高为48.4%;监测菌株对两性霉素B、制霉菌素和5-氟胞嘧啶耐药率最低,平均耐药率分别为5.9%、6.3%和7.2%;氟康唑和伊曲康唑的耐药率最高,平均耐药率分别为53.1%和47.2%。结论老年住院患者容易引起深部真菌感染,感染部位以呼吸道为主,假丝酵母菌属是院内真菌感染的主要病原菌,尤以白色假丝酵母菌感染率最高;两性霉素B、制霉菌素和5-氟胞嘧啶的耐药率最低,氟康唑的耐药率最高,耐药性具有种间差异。OBJECTIVE To explore the condition of deep fungal infection,analyze the infection type of pathogen and monitor the sensitivity of the common anti-fungi drugs,to provide reference for the clinical treatment to deep fungal infection.METHODS A total of 6025 specimen collected from Jan 2009 to Dec 2009 were conducted the routine fungal culture,the isolated pure bacteria were randomly inoculated to the diagnosis reagent lath,the bacteria identification and drug sensitivity test were conducted by using the bacterial determination analysis software.RESULTS Totally 900 cases of deep fungal infection were occurred in hospital,685 cases were the elderly patients,aged over 60,accounted for 76.1%.The detection rate of the fungal infection in sputum was the highest with 54.8%,secondly was the urine with 13.4%.Candida infection took the highest 94.9% among the 900 strains of fungi,the following were 2.1%,1.6% and 1.4%.A total of 470 strains of C.albicans,accounted for 52.2%,were the major Candida to cause the fungal infection.The drug resistance rates of C.neoformans and C.rugosa in fungal infection were the lowest and the average rates were 6.8% and 9.1% respectively,while Malassezia with the highest 48.4%.The drug resistance rates of the monitoring strains to Amphotericin,Nystain and Flucytosine were the lowest,the average rates were 5.9%,6.3% and 7.2%,respectively,while the resistance rates of Fluconazole and Itraconazole were the highest,with a respective average rates of 53.1% and 47.2%.CONCLUSION The elderly inpatients are prone to get the deep fungal infection,respiratory tract is the major infected site.Candida is the major pathogen to cause fungal infection in hospital,especially the Candida albicans with the highest infection rate.The resistance rates of the hardly using anti-fungi drugs with greater poisonous side effect in clinics,such as Amphotericin,Nystain and Flucytosine,are the lowest,while the rate of the frequently using Fluconazole is the highest.The drug resistance presents a genus difference.

关 键 词：医院感染 深部真菌感染 病原菌 耐药性监测 

分 类 号：R379[医药卫生—病原生物学]