133例念珠菌血症临床与实验室分析  

Clinical features and laboratory analysis for 133 episodes of candidemia

作　　者：马春芳[1,2] 孔倩倩[2] 李芳秋[2] 蔡迁[2] 王颖[2] 黄梅[2] 韩丹丹[2] 

机构地区：[1]江苏大学基础医学与医学技术学院,江苏镇江212013 [2]南京军区南京总医院解放军临床中心实验科,南京210002

出　　处：《临床检验杂志》2013年第2期145-147,共3页Chinese Journal of Clinical Laboratory Science

基　　金：江苏省科技支撑计划-社会发展项目(BE2009673);南京军区医学科技创新重点课题(10Z027)

摘　　要：目的探讨医院内侵袭性念珠菌病(IC)的流行特征、耐药情况及血清学检测结果,为念珠菌感染的病原学诊断及合理用药提供依据。方法收集2009～2011年间南京军区南京总医院全部血培养念珠菌阳性病例进行回顾性分析。结果共检出念珠菌血症133例。菌株主要为热带念珠菌(28.6%)、白念珠菌(23.3%)和近平滑念珠菌(19.5%)。对抗真菌药物的敏感率依次为:伏立康唑(97.8%)、伊曲康唑(69.2%)、氟康唑(45.4%)、酮康唑(38.9%)。31例检测了血清(1,3)-β-D-葡聚糖(BG)水平,阳性率为48.3%(15/31);102例检测了血清抗烯醇化酶(Eno)抗体,阳性率为60.8%(57/102);23例同时进行抗Eno抗体和BG检测,阳性率为73.9%(17/23)。结论引起念珠菌血症的病原体主要为热带念珠菌、白念珠菌和近平滑念珠菌。对氟康唑均有不同程度的耐药。联合血清学检测有助于辅助诊断念珠菌血症。Objective To investigate the epidemiological features, drug resistance and results of serological tests of invasive candidia- sis （ IC）, and provide informations of etiologic diagnosis and therapy for candida infection. Methods A retrospective study was con- ducted to analyze all the patients whose blood cultures were identified as positive for Candida spp. from January 2009 to December 2011. Results A total of 133 cases were identified as candidemia. The percentage of the most common 3 Candida spp. isolates was as follows ： Candida tropicalis （ 28.6% ）, Candida albicans （ 23.3% ） and Candida parapsilosis （ 19.5% ）. The susceptibility to anti- fungal agents was as follows ： voriconazole （＇97.8%）, itraconazole （ 69.2% ）, fluconazole （ 45.4% ） , ketoconazole （ 38.9% ）. （ 1-3 ） -β-D-glucan （BG） was detected in 31 cases among whom 15 cases （48.3%） were positive. Enolase （Eno） antibody was detec- ted in 102 cases among whom 62 cases （60.8%） were positive. Both of BG and anti-Eno were simultaneously detected in 23 cases and 17 of them were double-positive （73.9%）. Conclusion The most popular pathogens were Candida tropicalis, followed by Candida albicans and Candida parapsilosis. All of them became resistant to fluconazole to varying degrees. Combined detection of 2 serological markers should be helpful for diagnose of candidemia.

关 键 词：念珠菌血症 流行病学 实验室诊断 

分 类 号：R446.5[医药卫生—诊断学]