念珠菌血流感染特点分析  

The analysis of characteristic of candidemia

作　　者：答嵘[1] 石红[1] 刘万静 吴友伟[1] 王伟[2] 

机构地区：[1]西安交通大学第一附属医院检验科,西安710061 [2]西安交通大学第一附属医院神经外科,西安710061

出　　处：《检验医学与临床》2017年第4期458-460,共3页Laboratory Medicine and Clinic

基　　金：国家自然科学基金项目(81000767);西安交通大学第一附属医院基金资助项目(2014YK30)

摘　　要：目的探讨血培养真菌的检出情况并进行病原学分布与药敏试验,分析念珠菌在血流感染中的分布特点。方法该院2012年11月至2016年3月的血培养结果为真菌的标本,结合真菌种类、阳性报警时间(TTP)、标本送检科室、感染来源与氟康唑药敏试验结果进行分析。结果血培养分离出真菌97株,非重复分离株为53株,均为念珠菌。白色念珠菌最常见,为16株(30.19%)。热带念珠菌TTP[(20.28±1.36)h]最短,新生隐球菌TTP[(72.62±6.18)h]最长,白色念珠菌[(36.99±3.28)h]与近平滑念珠菌[(40.18±4.22)h]TTP相似居中。念珠菌血症前3位科室为血液内科9株(16.98%)、肝胆外科8株(15.09%)、神经外科6株(11.32%)。感染来源尿液最常见,其次是导管与引流液。所有菌株对氟康唑敏感。结论念珠菌血症白色念珠菌最常见,但是非白色念珠菌需引起重视。血培养单瓶(需氧瓶)阳性且TTP大于36h,需考虑念珠菌血症。泌尿系感染、导管相关血流感染、手术部位感染是念珠菌血症的重要感染源。Objective To study the characteristics of candidemia through analyzing the pathogens distribution and drug susceptibility of blood culture positive cases.Methods A retrospective study was conducted in the First Affiliated Hospital of Xi′an Jiaotong University between November 2012 and March 2016.Data of patients who were diagnosed as fungal infection by blood culture were collected.Furthermore,the factors,including the species of fungi,time to positivity（TTP）,departments,the origins of infection and fluconazole sensitivity,were analyzed.Results This study enrolled 97 strains of fungi,including 53non-repeated strains,all of which were Candida.Candida albicans is the most common strains,including 16strains（30.19%）.The shortest TTP was found in Candida tropicalis（20.28±1.36）h,while the longest one was discovered in Cryptococcus neoformans（72.62±6.18）h,and the median ones were detected in Candida albicans（20.28±1.36）h and Candida parapsilosis（40.18±4.22）h.The top three departments detected candidemia were department of hematology（9 strains,16.98%）,department of hepatobiliary surgery（8 strains,15.09%）and department of neurosurgery（6 strains,11.32%）.The most common origin was urine,followed by catheter and drainage.All of the strains were sensitive to fluconazol.Conclusion Although Candida albicans was the most common Candida in candidemia,non-Candida albicans should be focused on.Candidemia should be suspected when the blood culture showed single bottle positive with TTP exceeding 36 hours.Urinary tract infection,catheter related blood stream infections and surgical site infection were important origins of candidemia.

关 键 词：血培养 念珠菌 病原学分布 阳性报警时间 

分 类 号：R644[医药卫生—外科学]