非粒细胞缺乏患者假丝酵母菌属血流感染的临床分析  

Clinical analysis of Candidacausing bloodstream infections in non-agranulocytosis patients

作　　者：刘学花[1] 李玲[1] 

机构地区：[1]天津市人民医院感染免疫科,天津300121

出　　处：《中华医院感染学杂志》2014年第6期1336-1338,共3页Chinese Journal of Nosocomiology

基　　金：天津市卫生局基金资助项目(09KZ55)

摘　　要：目的探讨非粒细胞缺乏患者假丝酵母菌属血流感染病原菌分布及临床特征,为临床经验性治疗提供依据。方法回顾性分析2010年12月-2012年12月49例非粒细胞缺乏患者假丝酵母菌属血流感染临床资料,记录每份病历的年龄、基础疾病、中心静脉导管留置时间、抗菌药物应用史、临床表现、病原学、外周血白细胞计数、C-反应蛋白、降钙素原、血清1,3-β-D-葡聚糖及预后情况,采用法国生物梅里埃公司生产的VITEK AMS-60全自动微生物分析仪及YBC酵母菌卡菌种鉴定,用ATBFUNGUS2INT酵母药敏试剂条进行药敏试验,所有数据采用SPSS 13.0统计软件进行处理。结果 49例假丝酵母菌血流感染患者送检标本检出病原菌白色假丝酵母菌20株占40.8%,近平滑假丝酵母菌13株占26.5%,热带假丝酵母菌7株占14.3%;假丝酵母菌血流感染临床特征表现为高热、寒颤、中性粒细胞及C-反应蛋白、降钙素原增高,1,3-B-D葡聚糖检测阳性率42.9%;所有假丝酵母菌对氟康唑均敏感。结论非粒细胞缺乏患者假丝酵母菌血流感染主要病原菌为白色假丝酵母菌及近平滑假丝酵母菌,主要见于导管相关性血流感染;应重视血培养以早期诊断和及时治疗。OBJECTIVE To explore the distribution of Candida causing bloodstream infections in non-agranulocytosis patients and analyze the clinical features so as to provide basis for clinical empirical treatment. METHODS The clinical data of 49 non-agranulocytosis patients with Candida bloodstream infections, who were treated in the hospital from Dec 2010 to Dec 2012, were retrospectively analyzed, then the age, underlying disease, central venous catheter indwelling time, history of use of antibiotics, clinical manifestations, etiology, peripheral blood leukocytes counts, C-reactive protein, procalcitonin, serum 1,3-[3-D-glucan , and prognosis of each case were recorded, the identification of the strains was performed by using VITEK AMS-60 automatic microorganism analyzer of BioM%rieux, France and the YBC yeas＊ card, the drug susceptibility testing was carried out with the use of ATBFUNGUS2INT drug susceptibility test strips, and all the data were statistically analyzed with the use of SPSS 13.0 software. RESULTS Of the submitted specimens obtained from the 49 cases of Candida bloodstream infections, totally 20 strains of Candida albicans, 13 strains of Candida parapsilosis, and 7 strains of Candida tropicalis have been isolated, accounting for 40. 8%, 26. 50%, and 14. 3%, respectively. The clinical manifestations of the patients with Candida bloodstream infections included the hyperpyrexia, shiver, and elevated level of neutrophils, C-reactive protein, and procalcitonin; the positive rate of the 1,3-B-D glucan was 42.9%. All the species of Candida were susceptible to fluconazole. CONCLUSION The C. albicans and C. parapsilosis are the main species of pathogens causing bloodstream infections in the non-agranulocytosis patients, and the catheter- related bloodstream infection is the most common; it is necessary to attach great importance to the blood culture and timely treatment.

关 键 词：假丝酵母菌属 血流感染 临床特征 药敏分析 

分 类 号：R379[医药卫生—病原生物学]