异基因造血干细胞移植患者假丝酵母菌属感染分析  

Analysis of Candidainfection in patients after allogeneic hematopoietic stem cell transplantation

作　　者：刘芳[1] 何晓峰[1] 张虎[1] 马文杰[1] 吴镝[1] 杨得明 焦立群[1] 曹晋桂[1] 

机构地区：[1]空军总医院感染管理科,北京100142

出　　处：《中华医院感染学杂志》2014年第20期5010-5012,共3页Chinese Journal of Nosocomiology

基　　金：中华医院感染控制研究基金资助项目(ZHYY2013-001)

摘　　要：目的了解医院移植病房异基因造血干细胞移植患者假丝酵母菌属感染现状及耐药性分析,为异基因造血干细胞移植患者抗感染治疗提供依据。方法对2008-2013年血液科移植病房290例住院患者送检标本进行细菌鉴定,细菌鉴定采用VITEK-2Compact全自动微生物鉴定仪及科玛嘉显色培养基,用ATB fungs 3检测假丝酵母菌属的药物敏感性,数据采用WHONET5.4软件进行处理。结果 290例异基因造血干细胞移植术患者发生假丝酵母菌属感染35例,感染率为12.07%;共分离出35株假丝酵母菌属,其中白色假丝酵母菌最多15株占42.86%,其次为热带假丝酵母菌11株占31.43%;标本来源以口腔拭子为主占31.42%,其次为血液、眼拭子、痰液,分别占17.14%、14.29%、14.29%;白色假丝酵母菌及热带假丝酵母菌对氟胞嘧啶、两性霉素B的敏感率均为100.00%,对氟康唑、伊曲康唑及伏立康唑的敏感率均≥80.00%。结论异基因造血干细胞移植患者临床分离的假丝酵母菌耐药现象呈上升趋势,本研究为临床经验用药提供了一定的依据。OBJECTIVE To determine the Candida distribution and drug resistance in patients after allogeneic hematopoietic stem cell transplantation in the hospital from 2008 to 2013 ,and provide the basis of anti-infective therapy for these patients .METHODS The VITEK-2 compact full-automated microbial identification system and the CHR Candida Magar were used to identify the bacteria separated from 290 patients after allogeneic hematopoietic stem cell transplantation during 2008 to 2013 .ATB fungis 3 was used to detect the antibiotic resistance of the Candida strains and the data were processed by WHONET5 .4 .RESULTS There were 35 cases of Candida infection in the 290 patients after allogeneic hematopoietic stem cell transplantation .The infection rate was 12 .07% .Totally 35 strains of Candida were isolated ,including 15 strains of Candida albicans （42 .86% ） , followed by 11 strains of Candida tropicalis （31 .43% ） .Among the 35 strains of Candida ,the specimens were mainly from oral swabs （31 .42% ） ,followed by blood （17 .14% ） ,eye swabs （14 .29% ） and sputum （14 .29% ） . C .albicans and C .tropicalis had the sensitivity of 100 .00% to flucytosine and amphotericin B and the sensitivity of ≥ 80 .00% to fluconazole , itraconazole and voriconazole .CONCLUSIONS The drug resistance of Candida separated from the patients after allogeneic hematopoietic stem cell transplantation had an increasing trend .This study provided some evidence for the clinical experience of drug use .

关 键 词：异基因造血干细胞移植 假丝酵母菌属 感染 

分 类 号：R379[医药卫生—病原生物学]