肝病住院患者真菌感染调查与药敏分析  

Prevalence of fungal infection in hospitalized patients with liver diseases and analysis of drug susceptibility

作　　者：季柏林[1] 雷永良[2] 徐丽霞[1] 林群[1] 周飞雪[1] JI Bo-lin LEI Yong-liang XU Li-xia LIN Qun ZHOU Fei-xue(Lishui City Chinese Medicine Hospital, Lishui, Zhejiang 323000, Chin)

机构地区：[1]浙江省丽水市中医院检验科,浙江丽水323000 [2]丽水市疾病预防控制中心,浙江丽水323000

出　　处：《中华医院感染学杂志》2017年第5期1047-1049,1057,共4页Chinese Journal of Nosocomiology

基　　金：浙江省医药卫生科技计划基金资助项目(2014KBY318)

摘　　要：目的观察肝病住院患者真菌感染情况,并分析其药敏结果。方法选择医院2011年1月-2015年12月收集标本中培养出真菌1 000例住院肝病患者进行研究,收集患者的真菌培养结果及药敏试验结果。结果 1000例肝病患者分离出1410株真菌中,酵母样真菌1189株占84.3%,丝状真菌221株占15.7%;1189株酵母样真菌中,痰及咽拭子感染737株占62.0%,胸腹水和尿感染分别为146株占12.3%和140株占11.8%;221株丝状真菌中,痰及咽拭子感染202株占91.4%。酵母样真菌中,对氟康唑、伊曲康唑、两性霉素和伏立康唑的耐药率分别为12.1%、2.3%、0.3%和1.9%;丝状真菌中,对氟康唑、良性霉素、伊曲康唑和伏立康唑的耐药率分别为93.7%、16.7%、5.9%和4.5%;酵母样真菌对氟康唑、伊曲康唑、良性霉素和伏立康唑的耐药率均低于丝状真菌(P<0.05)。结论住院肝病患者以酵母样真菌感染为主,白假丝酵母菌的感染率最高,且对抗真菌药的耐药率均低于热带假丝酵母菌。OBJECTIVE To observe the prevalence of fungal infection in hospitalized patients with liver diseases and analyze the result of drug suseeptibility testing. METHODS From Jan 2011 to Dec 2015, a total of 1000 hospitalized patients who were cultured positive for fungi were enrolled in the study. The results of fungal eulture and drug suseeptibility testing were eolleeted. RESULTS Totally 1410 strains of fungi were isolated from the 1000 patients with liver diseases, including 1189 （84. 3%） strains of yeast-like fungi and 221 （15.7%） strains of filamentous fungi. Of the 1189 Strains of yeast-like fungi, 737 （62.0%） were isolated from sputum and throat swab, 146 （12. 3%） were isolated from pleural effusion, and 140 （11.8%） were isolated from urine. Of the 221 strains of fila- mentous fungi, 202 （91.4%） were isolated from sputum and throat swab. The drug resistance rates of the yeast- like fungi to fluconazole, itraconazole, amphotericin, and voriconazole were 12.1%, 2.3%, 0.3%, and 1.9%, respectively. The drug resistance rates of the filamentous fungi to fluconazole, amphotericin, itraconazole, and voriconazole were 93.7%, 16.7%, 5.9%, and 4.5%, respectively. The drug resistance rates of the yeast-like fungi to fluconazole, itraconazole, amphotericin, and voriconazole were lower than those of the filamentous fungi （P〈0.05）. CONCLUSION The yeast-like fungi infection is dominant among the hospitalized patients with liver diseases, the incidence rate of Candida albicans infection is the highest, and the drug resistance rate of the C. al- bicans to antifungal agents is lower than that of the C. tropicalis.

关 键 词：肝病 真菌 白假丝酵母菌 热带假丝酵母菌. 

分 类 号：R379[医药卫生—病原生物学]