5年内院内感染假丝酵母菌菌群分布及耐药性分析  

Distribution and drug resistance of Candida infection in hospital within 5 years

作　　者：王兆龙[1] 张养民[1] WANG Zhao-long;ZHANG Yang-min(Department of Blood Transfusion,Xi'an Central Hospital,Xi'an 710000,Shaanxi,CHINA)

机构地区：[1]西安市中心医院输血科,陕西西安710000

出　　处：《海南医学》2021年第9期1123-1127,共5页Hainan Medical Journal

基　　金：陕西省重点研发计划项目(编号:2017SF-234)。

摘　　要：目的了解医院临床感染标本中假丝酵母菌的分布及耐药现状,为临床合理应用抗真菌药物提供实验依据。方法回顾分析2015年1月至2019年12月西安市中心医院院内感染标本中分离出的假丝酵母菌的菌群分布及耐药性情况,鉴定应用VITEKⅡ全自动细菌鉴定分析仪,药物敏感试验采用纸片扩散法,按CLSI标准及相关标准进行,并采用WHONET5.6软件进行数据分析。结果从临床标本中5年内共分离到1634株假丝酵母菌,其中白色假丝酵母菌分离率最高,占55.57%,热带假丝酵母菌占31.21%;其中各科室检出率以呼吸科最多,占19.52%,其次是老年病科占13.71%;临床感染标本来源以痰液为主,占38.43%,其次为中段尿,占27.17%,两者占标本总数的65.60%。4种抗真菌药物中两性霉素B对假丝酵母菌敏感性比较好,耐药率在0.2%以下;氟康唑对白色假丝酵母菌的耐药率为0.52%,对热带假丝酵母菌的耐药率为31.20%,对光滑假丝酵母菌的耐药率为9.09%。结论临床分离假丝酵母菌感染中以白色假丝酵母菌和热带假丝酵母菌为主,其感染标本来源仍以痰和尿为主,5年间,假丝酵母菌对氟康唑和伏立康唑耐药率有逐渐增加趋势,而对伊曲康唑和两性霉素B耐药性未见明显变化趋势,随着广谱抗菌药物越来越滥用,临床应高度重视真菌的检测及耐药性变化。Objective To comprehend the distribution and drug resistance of Candida Strains in the clinical samples in the hospital,and to provide experimental basis for clinical rational use of antifungal drugs.Methods The species distribution and drug resistance of the Candida isolates from infected specimens in Xi'an Central Hospital from Jan.2015 to Dec.2019 were analyzed retrospectively.VITEKⅡautomated microbiaI identification system was used to identify the clinical isolates,and the disk diffusion method to perform the antifungal susceptibility test were used.The drug sensitivity results were recorded according to Clinical Laboratory Standards Institute(CLSI)standards,US and correlate standards.The data was analyzed by the software WHONET 5.6.Results Among 1634 strains of Candida isolates,the most common specie was Candida albicans with the proportion of 55.57%,followed by Candida tropicalis(31.21%).The most predominant departments for infection was Department of Respiratory Medicine(19.52%),followed by Department of Geriatrics(13.71%).The main source of clinical infection was sputum,accounting for 38.43%,followed by middle urine,accounting for 27.17%,and the two sources accounted for 65.60%of total specimens.Amphotericin B showed the best sensitivity among the 4 kinds of anti-fungal drugs,with the lowest resistance rate(less than 0.2%).The resistant rates of C.albicans isolates,C.tropicalis isolates and C.glabrata isolates to fluconazol were 0.52%,31.20%and 9.09%,respectively.Conclusion C.albicans and C.tropicalis are the most common pathogen of Candidal infection in the clinical samples.The source of infected specimen is mainly sputum and urine.The resistance rate of Candida to fluconazole and voriconazole increased gradually in 5 years.However,the resistance rate of the Candida strains to itraconazole and amphotericin B has no obvious variation trend.With the exacerbation of the broad-spectrum antibacterial drug abuse,it is necessary to strengthen the detection of drug resistance of Candida and the variation of th

关 键 词：菌群分布 假丝酵母菌属 药物敏感性试验 耐药性 医院内感染 广谱抗菌药 

分 类 号：R378[医药卫生—病原生物学]