尿石症患者并发真菌感染的菌群分布、药敏及危险因素分析  

Analysis of microflora distribution, drug susceptibility and risk factors of fungal infection in patients with urolithiasis

作　　者：叶俊兵 叶利洪[1] 何建松[1] 李王坚[1] 李峰[1] 万俊彦 YE Junbing;YE Lihong;HE Jiansong;LI Wangjian;LI Feng;WAN Junyan(Department of Urology,Shaoxing Hospital of China Medical University,Shaoxing 312000,China;Department of Urology,First People’s Hospital of Zigong City,Zigong 643099,China)

机构地区：[1]中国医科大学绍兴医院泌尿外科,绍兴312000 [2]自贡市第一人民医院泌尿外科,自贡643099

出　　处：《中国真菌学杂志》2021年第6期384-387,402,共5页Chinese Journal of Mycology

摘　　要：目的对尿石症患者并发真菌感染的菌群分布特点、药敏特点以及真菌感染危险因素进行分析,为积极预防、合理用药提供依据。方法选取2017年1月—2019年12月于我院泌尿外科住院治疗确诊为尿石症且疑似感染患者480例。根据清洁中段尿培养结果,将真菌感染阳性者59例纳入观察组,真菌感染阴性者421例纳入对照组,采用SPSS 22.0软件进行统计分析。结果①真菌分布:59例真菌感染者中,以热带假丝酵母菌最多见,共20例,占33.9%。②药敏特点:真菌对两性霉素B、5-氟胞嘧啶、伏立康唑、氟康唑、伊曲康唑的耐药率分别为0、1.7%、16.9%、22.0%、23.7%;真菌对两性霉素B、5-氟胞嘧啶的耐药率均低于伏立康唑、氟康唑、伊曲康唑(P<0.01)。③危险因素:多因素Logistic回归分析结果显示糖尿病、低白蛋白血症、肾功能异常是真菌感染的独立危险因素(P<0.05)。结论本院尿石症患者真菌感染以光滑假丝酵母菌最多见,医务工作者应针对真菌感染危险因素采取措施积极预防,并根据药敏特点合理使用抗生素。Objective The characteristics of the distribution of pathogen,drug susceptibility and risk factors of fungal infection in urolithiasis patients were analyzed to provide evidence for actively prevention and rational drug use.Methods From January 2017 to December 2019,480 patients with urologic calculus and suspected infection diagnosed in the urology department of our hospital were selected.According to the results of urine culture,59 patients with fungal infection were included in the observation group,421 patients with non-fungal infection were included in the control group,SPSS 22.0 software was used for statistical analysis of the characteristics of the distribution of pathogenic fungi,drug susceptibility and risk factors of patients with fungal infection.Results①Fungal distribution:among the 59 cases of fungal infection,the candida tropicalis infections was the most common,accounting for 20 cases(33.9%).②Drug sensitivity characteristics:The resistance rates of fungi to amphotericin B,5-fluorocytosine,voriconazole,fluconazole and itraconazole were 0,1.7%,16.9%,22.0%and 23.7%,respectively.③Risk factors:Multivariate Logistic regression analysis showed that diabetes,hypoalbuminemia and abnormal renal function were independent risk factors for fungal infection(P<0.05).Conclusions The most common pathogenic fungus in urolithiasis patients in our hospital was candida tropicalis.Doctors should take measures to prevent fungal infection according to the risk factors and use antibiotics rationally.

关 键 词：尿石症 真菌 感染 药敏 危险因素 

分 类 号：R519[医药卫生—内科学]