2012年度侵袭性真菌耐药监测网(CHIF-NET)侵袭性酵母菌感染的分布特征  

Distribution characteristics of invasive yeast infections in China Hospital Invasive Fungal Surveillance Net(CHIF-NET)in 2012

作　　者：段思蒙 肖盟[1,2] 黄晶晶 王贺 张戈 张京家[1,2] 康巍 王瞳 肖玉玲 倪芳[5] 高岚美 叶丽艳[7] 郭鹏豪[8] 万喆[9] 陈中举[10] 杨青[11] 林洁[12] 胡庆丰[13] 李虹玲[14] 岳娜 崔兰英[16] 李刚[17] 范会[18] 苏丹虹[19] 刘丽文[20] 田素飞[21] 赵声远[22] 杜雪飞[23] 周宏伟[24] 徐英春[1,2] DUAN Simeng;XIAO Meng;HUANG Jingjing;WANG He;ZHANG Ge;ZHANG Jingjia;KANG Wei;WANG Tong;XIAO Yuling;NI Fang;GAO Lanmei;YE Liyan;GUO Penghao;WAN Zhe;CHEN Zhongju;YANG Qing;LIN Jie;HU Qingfeng;LI Hongling;YUE Na;CUI LanYing;LI Gang;FAN Hui;SU Danhong;LIU Liwen;TIAN Sufei;ZHAO Shengyuan;DU Xuefei;ZHOU Hongwei;XU Yingchun(Department of Clinical Laboratory,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing 100730,China;Beijing Key Laboratory for Mechanisms Research and Precision Diagnosisof Invasive Fungal Diseases,Beijing 100730,China;Dana(Tianjin)Biotechnology Co.,Ltd,Tianjin 300451,China;West China Hospital of Sichuan University,Chengdu 610041,China;Jiangsu Province Hospital,The First Affiliated Hospital with Nanjing Medical University,Nanjing 210029,China;Fujian Medical University Union Hospital,Fuzhou 350001,China;Medical School of Chinese PLA,Beijing 100036,China;The First Affiliated Hospital,SUN Yat-san University,Guangzhou 510080,China;Peking University First Hospital,Beijing 100034,China;Tongji Hospital,Tongji Medical College of HUST,Wuhan 4300030,China;The First Affiliated Hospital of the Zhejiang University School of Medicine,Hangzhou 310003,China;Sir Run Run Shaw Hospital,Hangzhou 310016,China;Zhejiang Province People’s Hospital,Hangzhou 310014,China;Xiangya Hospital,Central South University,Changsha 410008,China;General Hospital of Tianjin Medical University,Tianjin 300052,China;The First Affiliated Hospital of Harbin Medical University,Harbin 150001,China;General Hospital of Ningxia Medical University,Yinchuan 750001,China;Shandong Provincial Hospital,Jinan 250021,China;The First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China;The People’s Hospital of Liaoning Province,Shenyang 110000,China;The First Hospital of China Medical University,Shenyang 110001,China;Ruijin Hospital,Shanghai Jiaotong University of Medicine,Shanghai 200025,China;The Fouth Affiliated Hospital of Harbin Medical University,Harbin 150001,China;The Second Affiliated Hospital

机构地区：[1]中国医学科学院北京协和医学院北京协和医院检验科,北京100730 [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]丹娜(天津)生物科技有限公司,天津300451 [4]四川大学华西医院,成都610041 [5]江苏省人民医院(南京医科大学第一附属医院),南京210029 [6]福建医科大学附属协和医院,福州350001 [7]解放军总医院,北京100036 [8]中山大学附属第一医院,广州510080 [9]北京大学第一医院,北京100034 [10]华中科技大学同济医学院附属同济医院,武汉4300030 [11]浙江大学医学院附属第一医院,杭州310003 [12]杭州邵逸夫医院,杭州310016 [13]浙江省人民医院,杭州310014 [14]中南大学湘雅医院,长沙410008 [15]天津医科大学总医院,天津300052 [16]哈尔滨医科大学附属第一医院,哈尔滨150001 [17]宁夏医科大学总医院,银川750001 [18]山东省立医院,济南250021 [19]广州医学院第一附属医院,广州510120 [20]辽宁省人民医院,沈阳110000 [21]中国医科大学附属第一医院,沈阳110001 [22]上海交通大学医学院附属瑞金医院,上海200025 [23]哈尔滨医科大学附属第四医院,哈尔滨150001 [24]浙江大学医学院附属第二医院,杭州310052

出　　处：《中国真菌学杂志》2021年第4期234-242,共9页Chinese Journal of Mycology

基　　金：国家自然科学基金青年项目(81802049)。

摘　　要：目的目前我国侵袭性酵母菌发病率呈明显上升趋势,本研究旨在分析中国医院侵袭性真菌监测网(China Hospital Invasive Fungal Surveillance Net,CHIF-NET)2012年流行病学数据。方法研究数据来自中国的22家三级医院,共收集到1619株念珠菌。研究采用基质辅助激光解析电离飞行时间质谱,结合ITS测序技术进行菌种鉴定,用美国临床和实验室标准协会(CLSI)推荐的纸片扩散法(kirby-Bauer,K-B)测定氟康唑和伏立康唑药物敏感性。结果本研究标本类型中来自于外周血液标本的菌株626株,占38.67%,来自其他部位(包括腹水、脓肿、静脉导管、脑脊液、肺泡灌洗液、胆汁、胸水、组织、关节积液和胃液)标本993株,占61.33%,其中分离自腹水的菌株354株占21.87%,分离自脓肿的菌株159株占9.82%,分离自其余标本类型的菌株数量较少(<8%)。1619株念珠菌分离自除血液以外其他部位的菌种,以白念珠菌为主(491株占49.45%),其次为热带念珠菌(164株占16.52%),其余种数量较少(<11%)。检出侵袭性酵母菌患者中男性1006株占62.1%,女性612株占37.8%,年龄范围0~94岁,其中≥65岁患者498株占30.76%。在侵袭性念珠菌感染中,绝大部分白念珠菌对氟康唑和伏立康唑敏感[耐药率(R)<1%],其次为近平滑念珠菌(R<6%)及热带念珠菌(R<7%)。另外,不同念珠菌在不同的医疗机构有分布差异。结论中国侵袭性酵母菌感染的分布与多种因素有关,包括感染部位、地域、年龄等,故仍需持续监测。Objective Incidence rate of invasive yeasts increased significantly in China.This study reported the datas of the China Hospital Invasive Fungal Surveillance Net(CHIF-NET)in 2012.Methods A total of 1619 Candida strains were collected from 22 hospitals in China.The sensitivity of fluconazole and voriconazole were determined by matrix-assisted laser desorption/ionization time of flight mass spectrometry and ITS sequencing.The drug sensitivities of fluconazole and voriconazole were determined by kirby Bauer,K-B,recommended by the American institute of clinical laboratory standardization(CLSI).Results In this study,626 strains from blood samples accounted for 38.67%.There were 993 strains from other parts(including ascitic fluid,pus,venous catheter,cerebrospinal fluid,bronchoalveolar lavage fluid,bile,pleural fluid,tissue,hydrarthrosis and gastric juice),accounting for 61.33%.Among them,354 strains isolated from ascites accounted for 21.8%,159 strains isolated from pus accounted for 9.8%,and fewer strains isolated from other sample types(<8%).Among 1619 strains of Candida isolated Other parts except blood,491 strains were mainly Candida albicans,accounting for 49.45%,followed by 164 strains of Candida tropicalis,accounting for 16.52%,and the number of other species was small(<10%).Among the patients with invasive yeast detected,there were 1,006 male patients accounting for 62.1%and 612 female patients accounting for 37.8%.The age range was 0-94 years old,among which 498 patients≥65 years accounted for 30.76%.In invasive candida infection,most Candida albicans were sensitive to fluconazole and voriconazole(R<1%),followed by Candida parapsilosis(R<6%)and Candida tropicalis(R<7%).In addition,different Candida species have different geographical distribution.Conclusion Studies howed that the distribution of invasive yeast infection in China was related to many factors including infection site,region and age.Therefore,continuous monitoring is needed.

关 键 词：侵袭性念珠菌病 分布特征 氟康唑 伏立康唑 

分 类 号：R519[医药卫生—内科学]