艾滋病患者口咽念珠菌病的菌种分布及药物敏感性  

Species distribution and antifungal susceptibility of Candida sp. isolates from AIDS patients with oropharyngeal candidiasis

作　　者：沈银忠[1] 卢洪洲[1] 

机构地区：[1]上海市公共卫生临床中心,上海201508

出　　处：《中国抗生素杂志》2010年第11期873-876,880,共5页Chinese Journal of Antibiotics

基　　金：上海市卫生局青年科研项目(项目编号:2008Y030);"艾滋病和病毒性肝炎等重大传染病防治"科技重大专项(项目编号:2009ZX10003-017)

摘　　要：目的了解艾滋病患者口咽念珠菌(假丝酵母)病的菌种分布及对常用抗真菌药的敏感性,为其防治提供参考。方法收集艾滋病合并口咽念珠菌患者口咽拭子标本,进行真菌分离和鉴定,并采用Rosco Neo-Sensitab纸片扩散法检测菌株对两性霉素B、氟胞嘧啶、氟康唑及伊曲康唑的敏感性。结果从50例患者共分离出65株念珠菌,其中最常见的是白念珠菌(77%),其次是热带念珠菌(8%)、光滑念珠菌(6%)、克柔念珠菌(3%)、近平滑念珠菌(3%)及季也蒙念珠菌(3%)。所有菌株对两性霉素B均敏感,未发现白念珠菌对氟康唑耐药;非白念珠菌对氟康唑的耐药率为40%,非白念珠菌对氟康唑和伊曲康唑存在交叉耐药。结论白念珠菌是引起艾滋病患者口咽念珠菌病的主要致病菌,且对氟康唑敏感;非白念珠菌在临床的检出率高,且对三唑类药物的耐药率高。Objective To investigate species distribution and in vitro drugs susceptibility of Candida sp.isolates from AIDS patients with oropharyngeal candidiasis.Methods Nasopharyngeal swab specimens were collected from 50 newly diagnosed AIDS patients with oropharyngeal candidiasis,species isolation and identification were performed.We studied the frequency of resistance profile to amphotericin B,flucytosine,fluconazole and itraconazole of isolates of Candida sp,using Neo-Sensitabs tablet assay.Results 65 isolates of Candida sp.were isolated from 50 newly diagnosed AIDS patients with oropharyngeal candidiasis,C.albicans（77%） was the most common species,followed by C.tropicalis（8%）,C.glabrata（6%）,C.krusei（3%）,C.parapsilosis（3%）,C.guilliermondii（3%）.All these isolates were susceptible to amphotericin B,no C.albicans isolates were resistant to fluconazole,the overall resistance rate of non-albicans Candida isolates to fluconazole was 40%,of which showed cross-resistance to itraconazole.Conclusion C.albicans is the most frequent Candida species isolated from AIDS patients with oropharyngeal candidiasis and is susceptible to fluconazole,non-albicans Candida species are increasing,the resistance rate of non-albicans Candida isolates to azoles is high.

关 键 词：念珠菌属 艾滋病 口咽念珠菌病 药敏试验 

分 类 号：R379.4[医药卫生—病原生物学] R512.91[医药卫生—基础医学]