重症监护室患者体外插管假丝酵母茵属鉴定及耐药性分析  

Identification and drug-resistance analysis on Candida spp.isolated from external intubator used by ICU patients

作　　者：樊昕[1] 任晓萍[1] 杜丽颖[1] 王聪敏[1] 杨蓉娅[1] 

机构地区：[1]北京军区总医院全军皮肤病诊治中心,北京100125

出　　处：《中国感染控制杂志》2010年第6期396-399,共4页Chinese Journal of Infection Control

基　　金：国家自然科学基金项目(30700038);中国博士后科研基金面上项目(20080441270);中国博士后科研基金特别资助项目(200801039)

摘　　要：目的了解某医院重症监护室(ICU)患者实施体外插管中真菌感染及其耐药情况。方法采集该院ICU84例患者的各种插管标本161份,将其接种于假丝酵母菌显色培养基,API 20C AUX鉴定试剂盒作菌株鉴定,ATB FUN-3药敏测试试剂盒进行药敏试验。结果 161份标本中检出真菌98株(60.87%),以白假丝酵母菌(52株,53.06%)为主,其余依次为热带假丝酵母菌(14株,14.29%)、光滑假丝酵母菌(11株,11.22%)、近平滑假丝酵母菌(9株,9.18%)和克柔假丝酵母菌(12株,12.25%)。其中呼吸道插管分离60株(61.22%),留置导尿管25株(25.51%),静脉插管13株(13.27%)。分离菌株对5-氟胞嘧啶、两性霉素B和伏立康唑的耐药率均<10%,对伊曲康唑的耐药率为12.24%;而光滑假丝酵母菌、近平滑假丝酵母菌和克柔假丝酵母菌对氟康唑的耐药率均>45%。结论 ICU患者各种插管中真菌感染以白假丝酵母菌为主;呼吸道插管感染率最高;各类假丝酵母菌对5-氟胞嘧啶、两性霉素B和伏立康唑耐药性较低,而对氟康唑耐药性较高。Objective To investigate fungal infection and drug resistance of fungi in ICU patients with external intubation. Methods 16l specimens of intubator used by 84 ICU patients in a hospital were collected, and specimens were inoculated on Candidal ehromogenic medium , all strains were identified by API 20C AUX Kit,and drug sensitivity test were performed by ATB FUN-3 Kit. Results Ninety-eight （60. 87%） fungus strains were isolated from 161 specimens, most of which were Candida albicans （52, 53. 06%）, the next were Candida tropicalis （14, 14. 29%）, Candida glabrata （11, 11. 22%）, Candida parapsilosis （9, 9. 18%） , and Candida krusei （12, 12. 25%）. Sixty strains （61.22%） were isolated from respiratory intubator, 25（25. SLY00） from urethral catheter and 13（13. 27%） from venous cannula. Drug-resistant rate of isolated strains to 5-fluorocytosine, amphotericin B, and vorieonazole were all 〈10% , resistant rate to ilraconazloe was 12. 24% ; resistant rate of Candida glabrata, Candida parapsilosis and Candida krusei to fluconazol were all 〉45%. Conclusion Candida albicans is the main fungi in infection caused by external intubation; fungal infection rate in patients undergoing respiratory intubation is high than patients undergoing the other external intubation ; All kinds of Candida have low drug-resistance to 5 fluorouracil, amphotericin B and fluconazole and have high drug-resistance to flueonazole.

关 键 词：重症监护室 侵入性操作 真菌感染 假丝酵母菌属 抗药性 微生物 抗真菌药 插管 

分 类 号：R379.4[医药卫生—病原生物学]