慢性肝病患者假丝酵母菌感染的临床特征及耐药性分析  

Clinical feature and drug resistance analysis of Candida infection in patients with chronic liver disease

作　　者：杨耿侠[1] 陈铭[2] 栗光明 YANG Geng-xia;CHEN Ming;LI Guang-ming(General Surgery Center,Beijing Youan Hospital,Capital Medical University,100069,China)

机构地区：[1]首都医科大学附属北京佑安医院普通外科中心,100069 [2]首都医科大学附属北京佑安医院临床检验中心,100069

出　　处：《传染病信息》2021年第6期519-522,共4页Infectious Disease Information

基　　金：“十三五”国家科技重大专项(2017ZX10201101);北京市优秀人才计划(2018000021223ZK04);北京市属科研院所科技发展项目(院所合作Y-2020H8-1)。

摘　　要：目的分析慢性肝病患者假丝酵母菌感染的临床特征及其对抗真菌药物的耐药性,为临床合理用药提供依据。方法收集2017年3月1日—2018年3月1日首都医科大学附属北京佑安医院106例住院慢性肝病患者相关临床资料,并对检出的假丝酵母菌菌株进行体外药物敏感性(药敏)检测。结果106例假丝酵母菌感染者中,分离菌株以白色念珠菌为主,占43.4%,热带念珠菌是最常见的非白色念珠菌,占19.8%。白色念珠菌对5种常见抗真菌药物耐药率普遍较低,最高的是两性霉素B,为8.7%。白色念珠菌对氟康唑及伏立康唑耐药率明显低于非白色念珠菌,差异均有统计学意义(P均<0.05)。所有菌株均对伊曲康唑及两性霉素B的耐药率差异均无统计学意义(P均>0.05),所有菌株对5-氟胞嘧啶耐药率均较低,差异均无统计学意义(P均>0.05)。结论慢性肝病患者假丝酵母菌感染仍然是以白色念珠菌为主,其对常用抗真菌药物耐药率较低,临床应根据药敏结果合理选择药物。Objective To analyze the clinical feature of patients with Candida infection and their resistance to antifungal drugs,and provide evidence for reasonable clinical medication.Methods The related clinical data were collected from hospitalized patients with chronic liver disease in Beijing You’an Hospital,Capital Medical University from March 1st,2017 to March 1st,2018,and the drug sensitivity of the detected Candida strains was tested in vitro.Results Among the 106 cases of Candida infection,Candida albicans was the main isolates and the infection rate reached 43.4%.Candida tropicalis was the most common non-Candida albicans with an infection rate of 19.8%.The resistance rate of Candida albicans to five common antifungal drugs was relatively lower,while the maximal resistance was achieved against amphotericin B,accounting for 8.7%.The resistance rate of Candida albicans to fluconazole and voriconazole was significantly lower than that of non-Candida albicans,with statistically significant difference(P<0.05).There was no statistically significant difference in the resistance rate of all strains to itraconazole and amphotericin B(P>0.05),and the resistance rate of all strains to 5-fluorocytosine was relatively low,with no statistically significant difference(P>0.05).Conclusions Candida albicans is still predominant Candida infection in patients with chronic liver disease.The resistance rate of Candida albicans to commonly used antifungal drugs is relatively low.In clinical practice,drugs should be reasonably selected based on the drug sensitivity results.

关 键 词：假丝酵母菌 感染 慢性肝病 耐药性 白色念珠菌 抗真菌药物 临床特征 

分 类 号：R446.5[医药卫生—诊断学]