河北地区侵袭性酵母菌感染的分布特征  

Epidemiological characteristics of invasive yeast infection in Hebei province

作　　者：栗方 赵颖[3] 赵建宏 李志荣[4] 孙艳[5] 赵文申[6] 郭彦言[7] 张金艳 任宏涛[9] 魏宏莲[10] 董爱英[11] 王建升 刘金禄[13] 吴相琨[14] 刘冬青 谢守军[16] 郭秀华[17] 郭映辉 徐英春[3] 徐晓琳 LI Fang;ZHAO Ying;ZHAO Jian-hong;LI Zhi-rong;SUN Yan;ZHAO Wen-shen;GUO Yan-yan;ZHANG Jin-yan;REN Hong-tao;WEI Hong-lian;DONG Ai-ying;WANG Jian-sheng;LIU Jin-lu;WU Xiang-kun;LIU Doang-qing;XIE Shou-jun;GUO Xiu-hua;GUO Ying-hui;XU Ying-chun;XU Xiao-lin(Herbei Yanda Hospital,Hebei 065201;Chaoyang Hospital Affiliated to the Capital University of Medical Science,Beijing 100020,China)

机构地区：[1]河北燕达医院感染与疾病控制部,河北065201 [2]首都医科大学附属北京朝阳医院感染与微生物科,北京100020 [3]中国医学科学院北京协和医院检验科侵袭性真菌病机制研究与精准诊断北京市重点实验室,北京100730 [4]河北医科大学第二医院河北省临床检验中心,河北050000 [5]沧州市中心医院,河北061001 [6]邯郸市中心医院,河北056001 [7]河北省唐山市工人医院,河北063000 [8]河北医科大学第四医院,河北050019 [9]邢台市人民医院,河北054001 [10]河北医科大学第二医院,河北050000 [11]华北理工大学附属医院,河北063000 [12]河北省人民医院,河北050057 [13]河北北方学院附属第一医院,河北075000 [14]河北燕达医院,河北065201 [15]邯郸市第一医院,河北056002 [16]承德医学院附属医院,河北067000 [17]河北省武安市第一人民医院,河北056300 [18]河北省儿童医院,河北050030

出　　处：《中华医院感染学杂志》2018年第18期2761-2765,共5页Chinese Journal of Nosocomiology

基　　金：河北省科技计划基金资助项目(17277775D);辉瑞中国抗真菌科研基金资助项目(WS931592);杨森科学研究委员会中国分会(JRCC)研究基金资助项目(Z171100002217068)

摘　　要：目的调查河北地区15家三级教学医院2016-2017年侵袭性酵母菌感染现状,了解河北地区侵袭性酵母菌感染的流行病学分布特点。方法对临床检出侵袭性酵母菌进行菌株收集和统计,采用科玛嘉显色培养基和VITEK-2Compact YST卡进行菌种初筛鉴定;应用微生物质谱对所有菌株进行复核鉴定,对于疑难及少见菌株进行ITS测序分析。结果 2016-2017年15家三级教学医院共检出侵袭性酵母菌样真菌268株。其中以白假丝酵母为主,112株占41.79%,其次为热带假丝酵母52株占19.40%,近平滑假丝酵母38株占14.18%;标本类型包括血液标本131株占48.88%,无菌体液标本137株占51.12%;内科科室(血液科、肿瘤科、呼吸科)69株占25.75%,外科科室(普外科、神经外科)67株占25.00%;ICU 55株占20.52%;菌株复核正确率为83.96%(225/268)。结论侵袭性酵母菌感染中最常见的仍然是白假丝酵母,但是非白假丝酵母感染有不同程度的上升趋势。采用质谱检测可以有效提高疑难菌株的鉴定正确率,为临床治疗提供精准的病原学依据。OBJECTIVE To investigate the current status of invasive yeast infection in 15 tertiary teaching hospitals in Hebei province from 2016 to 2017 so as to understand the epidemiological characteristics of the invasive yeast infection in Hebei province.METHODS The invasive yeast strains that were isolated from clinical department were collected and statistically analyzed,and the strains were preliminarily screened and identified by using Chromogenic medium CHROMagar and Compact YST card,all of the strains were re-examined and identified by using microorganism mass spectrum,and the ITS sequencing analysis was performed for the difficult and rare strains.RESULTS Of totally 268 strains of invasive yeast-like fungi that were isolated from 15 tertiary hospitals between2016 and 2017,112（41.79%）were Candida albicans,52（19.40%）were Candida tropicalis,and 38（14.18%）were Candida parapsilosis.131（48.88%）were isolated from blood specimens,137（51.12%）strains were isolated from aseptic body fluid specimens.69（25.75%）strains were isolated from internal medicine departments（hematology department,oncology department,respiratory medicine department）,67（25.00%）strains were isolated from surgical departments（general surgery department,neurosurgery department）,and 55（20.52%）strains were isolated from ICU.The correct rate of reexamination of the strains was 83.96%（225/268）.CONCLUSION C.albicans remain the predominant species of invasive yeast,however,the incidence of infection caused by non-C.albican strains is increased unevenly.Mass spectrometry may effectively raise the correct rate of identification of difficult strains so as to provide etiological basis for clinical treatment.

关 键 词：侵袭性酵母菌 流行病学 分子生物学鉴定 

分 类 号：R519[医药卫生—内科学]