临床真菌感染的分布及药物敏感性分析  

Study of Distribution and Drug Resistance of Clinically Common Fungal Infection

作　　者：徐鸿绪[1] 沈映冰[2] 黄健宇[3] 杜玲[3] 

机构地区：[1]中山大学附属第一医院检验医学部,广东广州510080 [2]中山大学附属第六医院药剂科,广东广州510655 [3]中山大学附属第一医院东山院区检验科,广东广州510080

出　　处：《中华医院感染学杂志》2010年第15期2344-2346,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解临床真菌感染的类型、分布及药物敏感性状况,为临床感染性疾病提供病原学诊断和合理使用抗真菌药物的依据。方法常规培养分离出真菌,然后接种在科玛嘉显示培养基进行显色,并用法国生物梅里埃公司生产的API 20C AUX酵母菌鉴定到种,利用ATB FUNGUS3真菌药敏板条进行MIC法药敏试验。WHONET5.5软件对药物敏感试验的数据进行统计分析。结果 1244株深部真菌标本分别来源于内科、ICU、外科、呼吸科、妇产科等临床科室,标本检出率最高的前3位分别是:痰标本占43.81%,大便占11.66%,尿液和分泌物各占10.13%;在1244株真菌中,白色假丝酵母菌占56.83%,其次是光滑假丝酵母菌18.81%、热带假丝酵母菌14.23%、近平滑假丝酵母菌6.19%、克柔假丝酵母菌0.73%;分离菌株的敏感率分别为两性霉素B100.00%、伏立康唑98.23%、5-氟胞嘧啶96.30%、伊曲康唑77.49%。结论真菌感染以假丝酵母菌属最多见,非白色假丝酵母菌比例逐年增高,药敏结果显示对伊曲康唑产生了较强的耐药性;因此,提高真菌的检测手段,常规开展真菌药敏试验,进行耐药性监测,可以指导临床合理使用抗真菌药物。OBJECTIVE To study the type and species distribution and the sensitivity of the antifungal agents of fungal infection in our hospital to provide the evidence of clinical treatment by identification and susceptibility.METHODS Conventionally cultured and isolated fungi,and then inoculated on the CHROMagar chromogenic substrate,made the identification of species by API 20C AUX of France′s BioMerieux.And carried out the drug sensitive tests by ATB FUNGUS3.And the data of drug sensitive tests analyzed by WHONET5.5.RESULTS In 1244 clinical isolates of yeasts which came from medical department,ICU,surgical department,pneumology department,obstetrics and gynecology department and so on.The isolating rate of fungi from sputum was the highest,accounting for 43.81%.The follows were stools,accounting for 11.66% and urine and secretion,accounting for 10.13%.In 1244 clinical isolates of yeasts,the proportions of Candida albicans is 56.83%,other yeasts were C.glabrata（18.81%）,C.tropicalis（14.23%）,C.parapsilosis（6.19%）,and monilia krusei（0.73%）.Among the 4 antifungal agents,amphotericin B had the highest sensitivity rate（100.00%）,followed by voriconazole（98.23%）,5-flucytosine（96.30%）,itraconazole（77.49%）.CONCLUSIONS Candida are the most common pathogens in the 1244 fungal stains and Non-C.albicans are increasing.These invasive fungi performed strong resistance to itraconazole.So improveing the test facility,and carrying out routine drug sensitive test to monitor the antifungal agents resistance,are very important in making rational administration of antifungal agents.

关 键 词：真菌 医院感染 临床分布 耐药率 抗菌药物 

分 类 号：R379[医药卫生—病原生物学]