住院肿瘤患者酵母样真菌的菌株分布及药物敏感性分析  

Analysis of yeast-like distribution and drug sensitivity in hospitalized tumor patients

作　　者：黄旭纯 黄思赟 陈柳伊 朱红军[3] 许镒洧[1] 彭裕辉[1] 翁雪芬[1] Huang Xuchun;Huang Siyun;Chen Liuyi;Zhu Hongjun;Xu Yiwei;Peng Yuhui;Weng Xuefen(Department of Clinical Laboratory,Cancer Hospital of Shantou University Medical College,Guangdong Province,Shantou 515041,China;Department of Invasive Technology,Cancer Hospital of Shantou University Medical College,Guangdong Province,Shantou 515041,China;Department of Clinical Laboratory,Shantou Central Hospital,Guangdong Province,Shantou 515041,China)

机构地区：[1]汕头大学医学院附属肿瘤医院检验科,515041 [2]汕头大学医学院附属肿瘤医院介入科,515041 [3]广东省汕头市中心医院检验科,515041

出　　处：《中国医药》2020年第10期1630-1632,共3页China Medicine

基　　金：国家自然科学基金(31600632)。

摘　　要：目的探讨住院肿瘤患者酵母样真菌的菌株分布及对抗真菌药物的敏感率。方法 2015年1月至2018年12月在汕头大学医学院附属肿瘤医院住院肿瘤患者送检的各类标本中共分离出酵母样真菌139株,分析其菌种类型、临床标本来源以及主要酵母样真菌对抗真菌药物的敏感率。结果 139株酵母样真菌的菌种类型包括白色假丝酵母菌83株(59.7%),近平滑假丝酵母菌29株(20.9%),热带假丝酵母菌7株(5.0%),光滑假丝酵母菌6株(4.3%),克柔假丝酵母菌2株(1.4%),其他酵母样真菌12株(8.6%)。检出酵母样真菌较多的临床标本为血液24株(17.3%)、腹腔积液22株(15.8%)、痰20株(14.4%)、尿液17株(12.2%)、胸腔积液10株(7.2%)。白色假丝酵母菌和近平滑假丝酵母菌对氟康唑、伏立康唑、伊曲康唑、两性霉素B和氟胞嘧啶的敏感率均为100%。热带假丝酵母菌对氟康唑、伏立康唑和伊曲康唑的敏感率分别为71.4%(5/7)、71.4%(5/7)、42.9%(3/7),光滑假丝酵母菌对3种抗真菌药物的敏感率更低,均为16.7%(1/6),二者对两性霉素B和氟胞嘧啶均完全敏感。结论汕头大学医学院附属肿瘤医院住院肿瘤患者分离的酵母样真菌以白色假丝酵母菌为主。主要酵母样真菌对两性霉素B、氟胞嘧啶敏感率高,对氟康唑、伏立康唑和伊曲康唑出现不同程度的敏感率下降。Objective To investigate the distribution of yeast-like fungi and sensitivity rate of antifungal drugs in hospitalized tumor patients.Methods From January 2015 to December 2018,139 yeast-like fungi samples were isolated from hospitalized cancer patients.The strain types,clinical specimen sources and susceptibility of the main yeast-like fungi to antifungal drugs were analyzed.Results Among the 139 strains of yeast-like fungi,there were 83 strains of candida albicans(59.7%),29 strains of candida parapsilosis(20.9%),7 strains of candida tropicalis(5.0%),6 strains of candida glabrata(4.3%),2 strains of candida krusel(1.4%)and12 strains of other yeast-like fungi(8.6%).The main sources of yeast-like fungi were isolated from blood samples(24 strains,17.3%),ascites samples(22 strains,15.8%),sputum samples(20 strains,14.4%),urine samples(17 strains,12.2%)and pleural fluid samples(10 strains,7.2%).The sensitivity rates of fluconazole,voriconazole,itraconazole,amphotericin B and flucytosine for candida albicans and candida parapsilosis were all100%.Moreover,the sensitivity rates of fluconazole,voriconazole and itraconazole were 71.4%(5/7),71.4%(5/7)and 42.9%(3/7)for candida tropicalis;they were all 16.7%(1/6)for candida glabrata.The sensitivity rates of amphotericin B and flucytosine for candida tropicalis and candida glabrata were all 100%.Conclusions Candida albicans is the main fungus isolated from tumor patients.The main yeast-like fungi shows high sensitivity to amphotericin B and flucytosine,but the sensitivity to fluconazole,voriconazole and itraconazole decreased in varying degrees.

关 键 词：酵母样真菌 肿瘤 药物敏感性 

分 类 号：R389[医药卫生—医学寄生虫学]