2011年中国侵袭性假丝酵母种类及药物敏感性监测  

Surveillance of species and antifungal susceptibility of invasive Candida species isolated in china in 2011

作　　者：张京家 肖盟[1,2] 张戈 段思蒙[1,2] 康巍 王瞳 张延海 赵颖[1,2] 张丽 王贺 徐英春[1,2] ZHANG Jing-jia;XIAO Meng;ZHANG Ge;DUAN Si meng;KANG Wei;WANG Tong;ZHANG Yan-hai;ZHAO Ying;ZHANG Li;WANG He;XU Ying chun(Peking Union Medical College Hospital,Beijing 100730,China;不详)

机构地区：[1]北京协和医院检验科,北京100073 [2]"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 [3]河北燕达医院中心实验室,河北廊坊065201

出　　处：《中华医院感染学杂志》2020年第14期2081-2085,共5页Chinese Journal of Nosocomiology

基　　金：“十三五”国家科技重大专项基金资助项目(2018ZX10712001);北京市科技计划首都健康保障培育研究基金资助项目(Z181100001618015)。

摘　　要：目的本研究报告了2011年中国医院侵袭性真菌监测网的监测情况。方法包括来自中国的24家三级医院,共收集到1 407株假丝酵母。采用基质辅助激光解析电离飞行时间质谱结合内转录间隔区(ITS)测序技术确定到种,用临床实验室标准化纸片扩散法测定氟康唑和伏立康唑药物敏感性。结果共鉴定出17种假丝酵母。白假丝酵母是最常见的菌种(48.61%),其次是热带假丝酵母(19.05%)、近平滑假丝酵母复合体(15.21%)和光滑假丝酵母(11.02%),其他种数量较少(<7%)。标本类型中,从血流中分离得到假丝酵母最多(42.29%),其次是腹水(25.52%)、脓液(8.53%)、静脉导管(6.18%)和胆汁(5.33%),其他标本分离量较少(<5%)。在假丝酵母感染病例中,白假丝酵母和近平滑假丝酵母复合体大多对氟康唑和伏立康唑敏感(耐药株<5%)。热带假丝酵母对氟康唑和伏立康唑也大多敏感(耐药株<6%)。光滑假丝酵母对于氟康唑和伏立康唑的交叉耐药率较高(14.19%)。此外,菌株耐药情况与地域分布有关。结论中国真菌分布与国际其他地区有明显差异。对真菌耐药,仍需持续性的加强监测。OBJECTIVE To report the result of surveillance under China Hospital Invasive Fungal Surveillance Net 2011.METHODS Totally 24 tertiary hospitals of China were included in the study,involving 1407 strains of Candida.The species of the strains were identified and determined by using matrix-assisted laser desorption/ionization mass spectrometry combined with internal transcribed spacer(ITS)sequencing.The drug susceptibility to fluconazole and voriconazole was determined by means of disk diffusion method of Clinical and Laboratory Standards Institutes.RESULTS A total of 17 species of Candida were identified,Candida albicans(48.61%)was the most common species,followed by Candida tropicalis(19.05%),Candida parapsilosis(15.21%)and Candida glabrata(11.02%),and other species accounted for less than 7%.Among the types of specimens,42.29%were isolated from bloodstream specimens,25.52%were isolated from ascitic fluid specimens,8.53%were isolated from pus specimens,6.18%were isolated from venous catheter,5.33%were isolated from bile specimens,and less than 5%were isolated from other specimens.Among the cases of Candida infection,most of the cases of C.albicans and C.parapsilosis infections were susceptible to fluconazole and voriconazole,the drug resistance rate was less than 5%;most of the C.tropicalis were susceptible to fluconazole and voriconazole,and the drug resistance rate was less than 6%.The cross-resistance rate of the C.glabrata strains to fluconazole and voriconazole was high(14.19%).In addition,the drug resistance of the strains was associated with geographic regions.CONCLUSION The distribution of fungi in China varies significantly from that of other regions in the world.It is necessary to persistently strengthen the surveillance of antifungal resistance.

关 键 词：侵袭性假丝酵母病 氟康唑 伏立康唑 抗真菌药物敏感性 

分 类 号：R379.4[医药卫生—病原生物学]