肿瘤患者深部真菌感染治疗效果分析  

Analysis of treatment effect on deep fungal infections in cancer patients

作　　者：陈雪梅[1,2] 王毅[1,3] 刘颖[1,2] 殷家福[1,2] 杨红武[1,2] 汤琦[1,4] 

机构地区：[1]云南省肿瘤医院 [2]昆明医科大学第三附属医院药剂科,云南昆明650118 [3]昆明医科大学第三附属医院医院感染管理科,云南昆明650118 [4]昆明医科大学第三附属医院乳腺科,云南昆明650118

出　　处：《中华医院感染学杂志》2014年第3期650-651,共2页Chinese Journal of Nosocomiology

基　　金：云南省科技基金资助项目(2012FB070)

摘　　要：目的通过研究肿瘤患者医院深部真菌感染状况、特点、病原菌分布及耐药性,分析肿瘤患者深部真菌感染的易感因素,主要感染部位、菌株及抗真菌感染治疗的效果。方法采用前瞻性及回顾性调查方法,调查分析2011年7月-2012年6月976例住院发生医院感染患者深部真菌感染及用药效果。结果 976例医院感染患者中深部真菌感染211例,占21.62%;检出的真菌以白色假丝酵母菌为主122株占57.82%;白色假丝酵母菌对伊曲康唑、氟胞嘧啶、两性霉素B未产生耐药性,对氟康唑、伏立康唑的耐药率均为0.82%;抗真菌治疗使用最多且有效的药物为氟康唑,使用157例,使用率74.41%。结论肿瘤患者免疫力低下,易导致深部真菌感染,应在药敏试验指导下,合理应用抗真菌药。OBJECTIVE To analyze the susceptible factors, main infection sites, strains and effect of anti-fungal infection treatment by investigating the deep fungal infection status, characteristics, pathogen distribution and drug resistance in hospitalized cancer patients. METHODS Investigation and analysis were performed on the deep fungal infections and medication effects on hospitalized patients from Jul. 2011 to Jun. 2012 using the prospective and retrospective investigation method. RESULTS In 976 cases of nosocomial infections, 211 cases were found to be deep fungal infections, accounting for 21.62 %; among the fungi detected, the Candida albicans were mostly found, accounting for 57. 82% （122strains）; C. albicans was not resistant to ltraconazole, flueytosine, amphotericin B, and the resistance rates of fluconazole, voriconazole were both 0. 82%. The mostly used and effective antifungal therapy drug was fluconazole, and was used in 157 cases with the utilization rate of 74.41%. CONCLUSION Immunocompromised cancer patients will easily catch the deep fungal infections, and the use of antifungal drugs should be rationally according to the results of drug susceptibility tests.

关 键 词：肿瘤患者 深部真菌 感染 治疗药物 

分 类 号：R181.32[医药卫生—流行病学]