河北地区侵袭性酵母样真菌的菌株分布及药敏分析  

Isolates distribution and drug sensitivity test of invasive yeast-like fungi infection in Hebei

作　　者：栗方 李志荣[3] 赵颖[4] 赵建宏 张延海[5] 董爱英 刘金禄 郭彦言[8] 孙艳 赵文申[10] 谢守军[11] 魏宏莲[12] 张金艳[13] 任宏涛[14] 王建升[15] 吴相锟[5] 光晓 刘冬青 杜红丽[18] 郭映辉 徐英春[4] 肖盟 杨文航 徐晓琳 LI Fang;LI zhi-rong;ZHAO Ying;ZHAO Jian-hong;ZHANG Yan-hai;DONG Ai-ying;LIU Jin-lu;GUO Yan-yan;SUN Yan;ZHAO Wen-shen;XIE Shou-jun;WEI Hong-lian;ZHANG Jin-yan;REN Hong-tao;WANG Jian-sheng;WU Xiang-kun;GUANG Xiao;LI Dong-qing;DU Hong-li;GUO Ying-hui;XU Ying-chun;XIAO Meng;YANG Wen-Hang;XU Xiao-lin(Herbei Yanda hopstial,Langfang 065201;Chao yang Hospital Affilliated to the Capital University of Medical Science,Beijing 100020,China;The Second Hospital of Hebei Medical University,Clinical Laboratory Center of Hebei Province,Shijiazhuang 050000,China;Department of Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing Key Laboratory for Mechanisms Research and Precision Diagnosis of Invasive Fungal Diseases,Beijing 100730,China;North China University of Science and Technology Affiliated Hospital,Tangshan 063000;The First Affiliated Hospital of Hebei North University School of Clinical Medicine,Zhangjiakou 075000;Department of Endocrinology,Tangshan Gongren Hospital,Tangshan 063000;Cangzhou Central Hospital,Cangzhou 061001;The Central Hospital of Handan,Handan 056001;Affiliated Hospital of Chengde Medical College,Chengde 067000;The Second Hospital of Hebei Medical University,Shijiazhuang 050000;Fourth Hospital Affiliated to Hebei Medical University,Shijiazhuang 050019;People's Hospital of Xingtai City,Xingtai 054001;Hebei Provincial People's Hospital,Shijiazhuang 050057;The First People's Hospital of Wu'an City,Wuan 056300;Handan First People's Hospital,Handan 056002;People's Hospital of Hengshui City,Hengshui 053000;Hebei Children's Hospital,Shijiazhuang 050030)

机构地区：[1]河北燕达医院感染与疾病控制部,廊坊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]河北医科大学第二医院河北省临床检验中心,石家庄050000 [4]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 [5]河北燕达医院,廊坊065201 [6]华北理工大学附属医院,唐山063000 [7]河北北方学院附属第一医院,张家口075000 [8]河北省唐山市工人医院,唐山063000 [9]沧州市中心医院,沧州061001 [10]邯郸市中心医院,邯郸056001 [11]承德医学院附属医院,承德067000 [12]河北医科大学第二医院,石家庄050000 [13]河北医科大学第四医院,石家庄050019 [14]邢台市人民医院,邢台054001 [15]河北省人民医院,石家庄050057 [16]河北省武安市第一人民医院,武安056300 [17]邯郸市第一医院,邯郸056002 [18]衡水市人民医院,衡水053000 [19]河北省儿童医院,石家庄050030

出　　处：《中国真菌学杂志》2019年第4期222-227,共6页Chinese Journal of Mycology

基　　金：河北省科技计划-重点研发计划项目资助(17277775D);中央高校基本科研业务费专项资金资助项目(3332018041);辉瑞中国抗真菌科研基金项目资助(WS931592)

摘　　要：目的调查河北地区16家三级教学医院侵袭性酵母样真菌的菌株构成、分布及其体外药敏特点,为临床抗真菌药物的合理应用提供依据。方法收集河北地区2016~2017年侵袭性酵母样真菌感染患者的菌株,对菌种构成进行分析,采用Sensititre YeastOne显色药敏板对9种抗真菌药进行药敏试验。结果共检出侵袭性酵母样真菌260株,其中白念珠菌是最主要的致病菌,占42.31%;非白念珠菌占57.69%,主要包括热带念珠菌19.23%、近平滑念珠菌18.08%和光滑念珠菌9.23%。白念珠菌对氟康唑、伏立康唑、伊曲康唑的耐药率分别为2.8%、1.9%和0.9%;热带念珠菌对氟康唑和伏立康唑的耐药率均为12.8%;近平滑念珠菌复合体对氟康唑和伏立康唑的耐药率分别为14.9%和10.6%;白念珠菌、热带念珠菌和近平滑念珠菌复合体对棘白菌素类抗菌物的耐药率几乎0%。结论侵袭性酵母样真菌感染中最常见的是白念珠菌感染,但是非白念珠菌感染已经超过50%。白念珠菌对抗真菌药物仍然有较高的敏感性,但对唑类药物的敏感率在不同种的念珠菌中存在差异。棘白菌素类对白念珠菌、热带念珠菌和近平滑念珠菌有很高的抗菌活性。Objective To investigate the composition,distribution and in vitro drug sensitivity of invasive yeast-like fungi infections isolates in 16 tertiary teaching hospitals in Hebei,and to provide a reference for the rational use of antifungal drugs.Methods The isolated strains of invasive yeast-like fungi infection patients in Hebei were collected,and the composition of the strains was analyzed,Sensititre YeastOne color sensitive plate was used to test the susceptibility of 9 antifungal agents.Results A total of 260 invasive yeast strains were detected,of which C.albicans was the most important pathogen(42.31%),and non-C.albica ns(57.69%),including C.tropicalis(19.23%),C.parapsilosis complex(18.08%)and C.glabrata(9.23%).The resistance rates of C.albicans to fluconazole,voriconazole and itraconazole were 2.8%,1.9%and 0.9%,respectively.The resistance rates of C.tropicalis to fluconazole and voriconazole were 12.8%.The resistance rates of C.parapsilosis complex to fluconazole and voriconazole were 14.9%and 10.6%,respectively.The resistance rate of C.albicans,C.tropicalis and C.parapsilosis complex to echinococcins was almost 0%.Conclusion C.albicans was the most common pathogen ofinvasive yeast-like fungi infection,but non-C.albicans infection had exceeded 50%.C.albicans was still highly susceptible to antifungal drugs,but the susceptibility rates of azoles were different among different Candida species.Echinomycins had high activity against C.albicans,C.tropicalis and C.parapsilosis.

关 键 词：侵袭性酵母样真菌 菌株分布 药敏试验 

分 类 号：R519[医药卫生—内科学]