2014-2018年临床无菌体液真菌的菌群分布及药敏分析  

Identification and Drug Resistance Analysis of the Isolated Fungi from Aseptic Body Fluid During 2014-2018

作　　者：杨淳[1] 张容[1] 张洁[1] 刘冬冬[1] 席寅[1] 刘晓青[1] 黎毅敏[1] 农凌波[1] YANG Chun;ZHANG Rong;ZHANG Jie;LIU Dong dong;XI Yin;LIU Xiao qing;LI Yi min;NONG Ling bo(The First Affiliated Hospital of Guangzhou Medical University,510120)

机构地区：[1]广州医科大学附属第一医院,510120

出　　处：《岭南急诊医学杂志》2020年第1期73-76,共4页Lingnan Journal of Emergency Medicine

基　　金：国家自然科学基金青年科学基金项目(81700080);国家自然科学基金(81770079)。

摘　　要：目的:了解我院无菌体液常见病原性真菌的菌群分布及耐药特点,为临床诊断、治疗提供依据。方法:连续收集广州医科大学附属第一医院2014年1月-2018年12月临床无菌体液真菌标本,用沙堡弱培养基进行分离培养,采用科玛显色培养基或VITEK-2鉴定菌种,并用ATBFUNGUS3进行药敏试验。结果:2014-2018年间检出的阳性样本数共260株,依次为29株、44株、48株、65株及74株;在260株真菌中,白色念珠菌是最主要的病原菌,占50.38%(131株)、其次是热带念珠菌(45株,17.31%)、光滑念珠菌(36株,13.85%)、近平滑念珠菌(25株,9.62%)。260株真菌对两性霉素B敏感率为100%;大部分菌株对氟康唑、伏立康唑的敏感率较高,在80%以上;克柔念珠菌则对氟胞嘧啶、氟康唑耐药,而伏立康唑敏感率达100%。光滑念珠菌、热带念珠菌、克柔念珠菌对伊曲康唑敏感率分别为60.00%、53.33%、66.67%。结论:临床无菌体液标本中真菌的检出率有逐年上升的趋势;无菌体液中真菌感染以白色念珠菌为主;大部分真菌对伊曲康唑的耐药率较高,而对其他常用的抗真菌药物有较好的敏感性。各临床科室及检验科均应加强对真菌感染和耐药性监测。Objective:To investigate the distribution and drug resistant characteristics of the fungi isolated from aseptic body fluid from 2014 to 2019.Methods:Fungal strains were isolated from January 2014 to December 2018 from the first affiliated hospital of Guangzhou medical university.The fungi were cultured on Saboraud medium and identified with CHRO Magar medium and VITEK 2 identify kit.ATBFUNGUS3 kit was used to perform drug susceptibility test.Results:From the samples with positive cultures of aseptic body fluid,260 strains were isolated.Among the 260 fungal strains,Candida albicans was the predominant fungal,accounting for 50.38%(131 strains),followed by Candida tropical(45 strains,17.31%),Candida glabrata(36 strains,13.85%),and Candida parapsilosis(25 strains,9.62%).The sensitivity of 260 strains to amphotericin B was 100%.Most of the strains were sensitive to fluconazole and voriconazole,with the sensitivity rate above 80%.Candida krusei is resistant to fluorouracil and fluconazole,while the sensitivity of voriconazole is 100%.The sensitivity rates of Candida glabrata,Candida tropicalis and Candida krusei to itraconazole were 60.00%,53.33%and 66.67%,respectively.Conclusion:The number of the fungi isolated from aseptic body fluid is increasing in recent years.Candida albicans was the predominant fungal in sterile body fluids infection.Most fungi have a high resistance rate to itraconazole whilesensitive to other common antifungal drugs.Monitoring fungal infection and drug resistance should be strengthened.

关 键 词：无菌体液 真菌 分布 药敏 

分 类 号：R446.5[医药卫生—诊断学]