我院细菌合并真菌感染或定植患者的临床特点及抗菌药物应用分析  

Clinical Characteristics and Antimicrobial Application of Bacterial Combined with Fungal Infection or Colonization Patients in Our Hospital

作　　者：钟慧[1] 粟永俊[2] 梁颖娥[1] 

机构地区：[1]南宁市第一人民医院药学部,南宁530022 [2]南宁市第一人民医院检验科,南宁530022

出　　处：《中国药房》2015年第5期628-630,共3页China Pharmacy

摘　　要：目的:探讨医院内细菌合并真菌感染或定植患者的临床特点及真菌检出前抗菌药物应用情况。方法:回顾我院2010年3月-2012年6月住院的细菌合并真菌感染患者的资料并分析。结果:细菌合并真菌感染或定植主要以老年、低蛋白血症、糖尿病、慢性阻塞性肺疾病患者为主,其分别占84.7%、39.7%、36.6%、30.5%;检出的病原菌以白色假丝酵母菌为主,占51.3%;尿标本培养出161株(占70.6%),痰标本培养出64株(占28.1%)。131例感染患者病死62例,死亡率高达47.3%。两性霉素B耐药率最低,占0.9%;伊曲康唑耐药率较高(占42.1%)。用药频度排序前5位分别为含β-内酰胺酶抑制剂的复方制剂、第三/四代头孢菌素、氟喹诺酮类、碳青霉烯类、抗厌氧菌类。结论:细菌合并真菌感染患者逐年增多,且老龄化、营养和免疫力低下以及合并基础性疾病的患者是双重感染的高发群体,且死亡率高。应重视真菌的变迁及双重感染的发生。OBJECTIVE： To investigate the clinical characteristics and antimicrobial application of nosocomial bacterial combined with fungal infection or colonization patients. METHODS： The data from Mar. 2010 to Jun. 2012 of inpatients with bacterial combined with fungal infection analyzed retrospectively. RESULTS： Bacterial combined with fungal infection or colonization mostly happened in senile, hypoalbuminemia, diabetes mellitus and COPD patients, accounting for 84.7% , 39.7% , 36.6% and 30.5%, respectively. Detected pathogenic bacteria were mainly Candida albicans, accounting for 51.3%. Urine specimen produced 161 strains, accounting for 70.6%, followed by sputum specimens produced 64 strains, accounting for 28.1%. Among 131 infection patients, there were 62 death cases, and the death rate was as high as 47.3%. The resistance rate of amphotericin B was the lowest, accounting for 0.9%; that of itraeonazole was the highest, accounting for 42.1%. Top 5 drugs in the list of DDDs were compound preparations of/%lactamase inhibitor, third and fourth generation cephalosporins, fluoroquinolones, carbapenems and anti-anaerobic agents. CONCLUSIONS： Bacteria combined with fungal infection patients are increased year by year. Ageing, low nutrition and immunity patients with underlying diseases are high-risk groups of dual infection with a high mortality rate; great importance should be attached to the changes of the fungus and dual infection.

关 键 词：细菌 真菌 抗菌药物 感染 

分 类 号：R379[医药卫生—病原生物学] R978.5[医药卫生—基础医学]