下呼吸道真菌感染的临床特点及耐药性分析  

Clinical feature and drug resistance analysis of lower respiratory tract fungal infection

作　　者：范晓云[1,2] 汪浩[1,2] 武晓兰[1,2] 谭红霞[1,2] 徐元宏[3] 

机构地区：[1]安徽医科大学第一附属医院老年呼吸内科,安徽合肥230022 [2]安徽医科大学呼吸病研究所,安徽合肥230022 [3]安徽医科大学第一附属医院检验科,安徽合肥230022

出　　处：《中国微生态学杂志》2011年第6期546-548,共3页Chinese Journal of Microecology

基　　金：安徽省高校省级自然科学研究项目(KJ2011A176);安徽省教育厅教学研究项目(20100350);国家青年基金培育计划(2010KJ13)

摘　　要：目的探讨住院患者下呼吸道真菌感染的临床特点,对其耐药性进行分析,以指导临床合理用药。方法回顾性调查2008年1月至2009年12月间安徽医科大学第一附属医院发生下呼吸道真菌感染的病例,并进行统计学分析。结果 374例下呼吸道真菌感染患者检出白色念珠菌253例(67.6%),光滑念珠菌74例(19.8%),热带念珠菌28例(7.5%),克柔念珠菌10例(2.7%),其他假丝酵母菌3例(0.8%),毛霉菌4例(1.1%),烟曲霉菌2例(0.5%)。本组资料药敏结果显示各种真菌对多种抗真菌药物敏感率较高,其中两性霉素B、伏立康唑和氟康唑的敏感率较高,而伊曲康唑的耐药率最高,达到12.2%。结论下呼吸道真菌感染仍以白色念珠菌感染为主,光滑念珠菌和热带念珠菌其次,3种念珠菌占总分离真菌的94.9%,5种抗真菌药物的耐药率以伊曲康唑最高,社区获得性感染患者预后明显优于医院感染患者。Objective To investigate the clinical feature and analyze the susceptibility of pathogens in inpatients with lower respiratory tract fungal infection, and provide evidence for clinical reasonable selection of antifungal drugs.Method The data of inpatients with lower respiratory tract fungal infection from Jan 2008 to Dec 2009 were analyzed retrospectively with statistical method.Result Among 374 cases of lower respiratory tract fungal infection,there were 253 cases of candida albicans（67.6%）,74 cases of candida glabrata（19.8%）,28 cases of candida tropicalis（7.5%）,10 cases of candida kruseis（2.7%）,3 cases of other candida species（0.8%）,4 cases of mold fungus（1.1%） and 2 cases of ropicalis（0.5%）.The result of drug sensitivity test showed that the fungi were sensitive to many antifungal agents.The sensitivity rates to amphotericin B,voriconazole and fluconazole were high,while the resistance rate to itraconazole was the highest（up to 12.2%）.Conclusion Candida albicans are still the main pathogen in patients with lower respiratory tract fungal infection,followed by candida glabrata and candida tropicalis.The infection rate of the three albicans was 94.9%.The drug resistance to itraconazole are the highest among five common antifungal agents.The prognosis of patients with community-acquired infection is better than that of nosocomial infections.

关 键 词：下呼吸道 真菌感染 耐药性 医院感染 

分 类 号：R379[医药卫生—病原生物学]