肺真菌感染的临床表现及药物敏感性分析  

An analysis of the clinical manifestion and drug sensitivity of pulmonary fungal infection

作　　者：刘自贵 裘雁秋 谭明珍 杨尧 朱淑媛[1] 

机构地区：[1]华西医科大学附属第一医院,610041

出　　处：《四川医学》2000年第7期585-587,共3页Sichuan Medical Journal

摘　　要：目的　了解医院肺真菌感染的临床特征及药物敏感状态。方法　对医院肺真菌感染危险因素、诊断、抗真菌药物敏感性及疗效进行分析。结果　 10 5例肺真菌感染者均有严重基础疾病 ,81例 (77.14% )用过抗生素 ,临床表现无特异性 ,对有呼吸道症状者及时作痰培养确诊 ;培养出真菌 111株 ,白色念珠菌及热带念珠菌分别为 71.17%及 10 .81% ;抗真菌药物敏感性分别为 AMB 5 6 .19%、5 - FC 5 5 .2 4%、KCZ 6 1.90 %、NYS 3 1.43%及 FCZ 6 4.76 % ;氟康唑治疗有效率80 .85 %。结论　严重基础病及长期用抗生素者肺部真菌感染率较高 ,积极治疗原发病、合理使用抗生素及肾上腺皮质激素等有利于预防肺部真菌感染 。Objective To study the clinical of pulmonary infection caused by fungi and to investigate the sensitivity of antifungal agents.Methods We made a clinical study and tested the drug sensitivity to 5 kinds of antimycoin in 105 cases (111 strains)from 1988 to 1998 according to the standards confirmed by the nosocomial infections monitoring and coordinating group of Ministry of Health.Results The nosocomial fungal infection occurred in 139 cases,and105(75.54%) of them were cases of pulmonary fungal infection.All of the 105 patients had underlying diseases such as hepatocirrhosis,COPD,severe hepatitis,and so on,and among them 81(71.14%) cases had been treated with antibiotics,37(35.24%)cases were mixed infection with presence of other bacteria,most of which were P.aeruginosa and K.pneumoniae.The chief symptoms were fever(71.43%),cough(81.9%)and non-specific manifestions.The candida albicans and C.tropcalis were the major pathogens(71.17% and 10.81% respectively).In vitro antifungal agents sensitive test demonstrated that 56.19% of fungal strains were sensitive to Amphotericin B,55.24% to 5 FC,61.90% to Ketoconazole,31.43% to Nystatin,and 64.76% to Fluconazol.The effective rate of Fluconazol was 80.85%.Conclusion Attention must be accorded to the pulmonary fungal infection.The measure necessary to prevent pulmonary fungal infection comprises treatment of original disease,rational treatment with antibiotics and adrenocorticoids,intensive fungal monitoring,etc.Fluconazol has efficacy in treating pulmonary fungal infection.

关 键 词：肺部感染 氟康唑 真菌感染 临床表现 药敏试验 

分 类 号：R563.9[医药卫生—呼吸系统]