重症急性胰腺炎患者真菌感染特征分析  

Characteristics of fungal infections in patients with severe acute pancreatitis

作　　者：张明刚[1] 段军[2] 陶永康[3] 杨华元[1] 杜时雨[1] 

机构地区：[1]中日友好医院消化内科,北京100029 [2]中日友好医院重症医学科,北京100029 [3]中日友好医院急诊科,北京100029

出　　处：《中华医院感染学杂志》2016年第16期3760-3762,共3页Chinese Journal of Nosocomiology

基　　金：国家科技部"十二五"支撑计划基金资助项目(2014BAI08B02)

摘　　要：目的探讨重症急性胰腺炎(SAP)患者并发真菌感染的菌群分布特点及耐药性,为临床合理用药提供科学依据。方法选择2012年3月-2015年1月医院确诊的SAP患者364例,采集患者感染分泌物进行真菌培养及药敏试验,观察感染部位及菌落分布特征,并分析其耐药性,数据采用WHONET 5.0软件进行统计分析。结果 364例SAP患者中有63例发生真菌感染,感染率17.31%;感染部位分布在全身各处,共96例次,以肺部感染为主,共34例次占35.42%;在并发真菌感染的63例SAP患者中,分离培养出真菌96株,以白色念珠菌为主,共52株占54.17%;热带念珠菌、克柔念珠菌、光滑念珠菌、近平滑念珠菌对伏立康唑敏感率高,均为100.00%。结论 SAP患者并发真菌感染主要是以白色念珠菌为主,肺部易感染,临床可采用伏立康唑进行抗感染治疗。OBJECTIVE To explore the bacterial colony distribution characteristics and drug resistance of fungal infections in patients with severe acute pancreatitis（SAP）,so as to provide the scientific evidence for clinical rational use of drugs.METHODS A total of 364 SAP patients diagnosed in hospital from Mar.2012 to Jan.2015 were selected.The infected secretions were collected to perform the bacterial culture and drug susceptibility test.The fungal infections sites and colony distribution characteristics were observed,and its drug resistance were analyzed.WHONET 5.0was used for data statistic analysis.RESULTS Totally 63 patients were checked out with fungal infections in 364 SAP patients,and the infection rate was 17.31%.The infection sites were distributed throughout the body with a total of 96 cases,pulmonary infections as the main kind had 34 cases for 35.42%.A total of 96 strains of fungi were cultured in 63 SAP patients with fungal infections,including mainly 52 strains of Candida albicens,accounting for 54.17%.The susceptibility rates of Candida tropicalis,Candida krusei,Candida glabrata,Candida parapsilosis to voriconazole were 100.00%.CONCLUSION C.albicans are the main pathogenic bacteria induced fungal infections in SAP patients,whose lung is particularly prone to infection,and voriconazole is suggested for clinical anti-infection treatment.

关 键 词：重症急性胰腺炎 真菌感染 病原菌 耐药性 

分 类 号：R379[医药卫生—病原生物学]