头颈部肿瘤患者口腔真菌感染耐药性分析  

Drug resistance of fungi causing oral infections in patients with head and neck cancer

作　　者：郑晓珍[1] 郑勤红[1] 邹燕[1] 吕珍[1] 王丹丹[1] 

机构地区：[1]衢州市人民医院放疗科,浙江衢州324000

出　　处：《中华医院感染学杂志》2014年第10期2389-2390,2396,共3页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科研基金资助项目(2013KYA115)

摘　　要：目的针对头颈部肿瘤放化疗患者口腔感染及真菌耐药性进行分析,为临床治疗提供参考依据。方法对2009年1月-2013年9月收治的605例头颈部肿瘤放化疗患者口腔咽拭子样本进行感染分析,并对检出真菌进行耐药性分析;采用SPSS17.0软件进行统计分析,计量资料以均数±标准差表示,采用t检验,计数资料采用χ2检验。结果 605例接受放化疗治疗的头颈部肿瘤患者发生口腔感染63例,感染率10.41%;共检测病原菌125株,其中细菌61株占48.80%,真菌64株占51.20%,以白色假丝酵母菌为主,31株占24.80%;主要真菌对益康唑、酮康唑耐药率较高,对氟康唑、氟胞嘧啶、两性霉素B耐药率较低,其中对两性霉素B最敏感,耐药率≤3.23%。结论头颈部肿瘤放化疗患者真菌感染率相对较高,其中白色假丝酵母菌感染较多,针对真菌感染患者采用的治疗药物中氟康唑耐药率较低,效果显著,同时也可以考虑氟胞嘧啶、两性霉素B的临床应用。OBJECTIVE To analyze the drug resistance of the fungi causing oral infections in head and neck cancer patients undergoing radiochemotherapy so as to provide guidance for clinical treatment. METHODS A total of 605 patients with head and neck cancer, who underwent the radiochemotherapy from Jan 2009 to Sep 2013, were en- rolled in the study, then the throat swab samples were collected from the patients with infections, the drug resistance of isolated fungi was analyzed; the statistical analysis was performed with the use of SPSS17.0 software, the measurement data were defined as mean＋ standard deviation and analyzed by using the t-test, and the count data were analyzed by means of the chi-square test. RESULTS Among the 605 head and neck cancer patients undergoing radiochemotherapy, the oral infections occurred in 63 cases with the infection rate of 10.41%. Totally 125 strains of pathogens have been isolated, including 61 （48.80%） strains of bacteria and 64 （51.20%） strains of fungi; the Candida albicans was dominant among the fungi, accounting for 24.80% （31 strains ）. The main species of fungi were highly resistant to econazole and ketoconazole, but the drug resistance rates to fluconazole, 5-flucytosine, and amphotericin B were low, and the strains were most susceptible to amphotericin B, with the drug resistance rate no more than 3.23%. CONCLUSION The incidence of fungal infections is high in the head and neck cancer pa- tients undergoing radiochemotherapy, and the C. albicans is the predominant species of fungi. Fluconazole can achieve significant effect on treatment of the fungal infections, meanwhile, flucytosine and-amphotericin B can also be applied in the hospital.

关 键 词：头颈部肿瘤 真菌感染 耐药性分析 

分 类 号：R379[医药卫生—病原生物学]