重症患者感染假丝酵母菌属的药物敏感性研究  

Drug sensitivity of Candidainfected by severe patients

作　　者：樊楚明[1] 杨欣悦[1] 任靖宇[1] 张洪波[1] 茹今 陈庆宁[2] 

机构地区：[1]云南省第一人民医院重症医学科,云南昆明650032 [2]云南省第一人民医院皮肤科,云南昆明650032

出　　处：《中华医院感染学杂志》2016年第5期976-978,共3页Chinese Journal of Nosocomiology

基　　金：云南省科技厅昆明医科大学联合基金资助项目(2014FZ066)

摘　　要：目的探讨重症患者假丝酵母菌属感染与药物敏感性,旨在为临床用药提供指导依据。方法 2010年1月-2014年12月入住ICU假丝酵母菌属培养阳性的重症患者312例,收集患者痰液、血液、中段尿、手术切口分泌物等,分析感染假丝酵母菌属分布与耐药性。结果 5年中,ICU重症患者假丝酵母菌属感染检出率为14.7%,且呈现逐年上升的趋势,差异有统计学意义(P<0.05);312株假丝酵母菌属包括白色假丝酵母菌占47.1%,光滑假丝酵母菌占33.7%,热带假丝酵母菌占13.5%,克柔假丝酵母菌占3.2%,近平假丝酵母菌和葡萄牙假丝酵母菌各占1.3%;假丝酵母菌属主要来自重症患者痰液181株占58.0%、尿液41株占13.1%、分泌物27株占8.7%;假丝酵母菌属对抗菌药物的耐药性以伊曲康唑最高为13.6%,依次为伏立康唑、氟康唑、氟胞嘧啶,对两性霉素B的耐药性为0;克柔假丝酵母菌、近平假丝酵母菌与葡萄牙假丝酵母菌对5种抗菌药物的耐药性均为0。结论重症患者假丝酵母菌属感染呈逐渐上升的趋势,主要发生于呼吸道,对两性霉素B敏感,对伊曲康唑耐药性高。OBJECTIVE To investigate the infections and drug sensitivity of Candidain severe patients,so as to provide guidance for clinical medication.METHODS From Jan.2010 to Dec.2014,312 cases of severe patients in ICU infected with Candida were collected.Their sputum,blood,urine,secretions of the wound were collected to make an analysis of the distribution and drug resistance of Candida.RESULTS During the 5years,the Candida infection rate of severe patients in ICU was 14.7%,and the proportion was increasing.The difference was significant（P〈0.05）;of the 312 Candida strains,the C.albicans accounted for 47.1%,C.glabrata accounted for33.7%,C.tropicalis accounted for 13.5%,C.krusei accounted for 3.2%,C.parapsilosis and C.lusitaniae accounted for 1.3%respectively.Candida were mainly from sputum samples with 181 strains,accounting for 58%,urine samples with 42 strains accounting for 13.1%,and secretion samples with 27 strains accounting for 8.7%.The Candida was highly resistant to itraconazole with a rate of 13.6%,followed by itraconazole,voriconazole,fluconazole and flucytosine.The Candida was totally sensitive to amphotericin B.C.krusei,C.parapsilosis and C.lusitaniae were totally sensitive to the 5antibiotics.CONCLUSIONPatients with severe Candidainfection are increasing and the infection mainly occurs in low respiratory tracts.The pathogens were sensitive to amphotericin B,which highly resistant to itraconazole.

关 键 词：重症患者 假丝酵母菌属 感染 药物敏感性 

分 类 号：R379.4[医药卫生—病原生物学]