广东省68家医院下呼吸道标本分离曲霉菌分布及其药物敏感性  

Aspergillus spp.isolated and drug sensitivity analysis from lower respiratory tract specimens in 68 hospitals of Guangdong Province

作　　者：郭鹏豪[1] 黄旭东[2] 吴劲松 蔡文莹[4] 陈雪琴 温见翔[6] 廖康[1] GUO Peng-hao;HUANG Xu-dong;WU Jin-song;CAI Wen-ying;CHEN Xue-qin;WEN Jian-xiang;LIAO Kang(First Affiliated Hospital of SunYat-Sen University,Guangzhou 520080,China;不详)

机构地区：[1]中山大学附属第一医院检验科,广东广州520080 [2]揭阳市人民医院检验科,广东揭阳522000 [3]深圳市人民医院检验科,广东深圳518000 [4]中山大学孙逸仙纪念医院皮肤科,广东广州520080 [5]梅州市人民医院检验科,广东梅州514000 [6]北京大学深圳医院检验科,广东深圳518000

出　　处：《中华医院感染学杂志》2022年第20期3047-3051,共5页Chinese Journal of Nosocomiology

基　　金：广东省医学科学技术研究基金资助项目(A2021425)。

摘　　要：目的分析广东地区下呼吸道标本分离曲霉菌的菌种及药物敏感性。方法对广东省68家医院2020-2021年度下呼吸道标本分离曲霉菌的数据进行分析。菌株鉴定通过形态学、基质辅助激光解析电离飞行时间质谱(MALDI-TOF MS)等方法;采用Sensititre Yeastone真菌药敏检测试剂盒检测两性霉素B、伏立康唑、伊曲康唑、泊沙康唑的最低抑菌浓度(MIC),卡泊芬净、米卡芬净的最低有效浓度(MEC)。结果68家医院下呼吸道标本共分离曲霉菌1569株。男性患者是女性患者的1.85倍,60岁以上占61.70%。烟曲霉是最常见的菌种,占66.79%,其次是黄曲霉16.19%、黑曲霉7.20%等。烟曲霉对于伏立康唑的敏感率为94.34%,对于两性霉素B、伊曲康唑、卡泊芬净的野生型菌株占比在93.58%~98.49%之间;黄曲霉和黑曲霉对于两性霉素B、伊曲康唑、伏立康唑、泊沙康唑、卡泊芬净的野生型菌株占比分别在92.45%~100.00%之间;黄曲霉对于两性霉素B的MIC_(50)为4μg/ml,MIC范围为1~4μg/ml;土曲霉对于两性霉素B的范围为2~4μg/ml。结论广东地区下呼吸道标本中曲霉菌以烟曲霉为主;三唑类及棘白菌素类药物对于曲霉菌具有良好的体外抗菌活性;两性霉素B的MIC分布明显偏高。OBJECTIVE To analyze the bacterial species and drug susceptibility of Aspergillus spp.isolated from lower respiratory tract specimens in Guangdong.METHODS The data on the isolation of Aspergillus from lower respiratory tract specimens from 68 hospitals in Guangdong province from 2020 to 2021 were analyzed.The strains were identified by morphology,matrix-assisted laser desorption ionization time-of-flight mass spectrometry(MALDI-TOF MS)and other methods.The Sensititre Yeastone fungal susceptibility test kit was used to detect the minimum inhibitory concentrations(MIC)of amphotericin B,voriconazole,itraconazole,posaconazole,and the minimum effective concentration(MEC)of caspofungin and micafungin.RESULTS A total of 1569 Aspergillus strains were isolated from lower respiratory tract specimens from 68 hospitals.Among the patients with Aspergillus isolates,male patients were 1.85 times as many as female patients.61.70%of patients were≥60 years old.The most common species was A.fumigatus,accounting for 66.79%,followed by A.flavus(16.19%)and A.niger(7.20%).The sensitivity rate of A.fumigatus to voriconazole was 94.34%,and the proportion of wild-type strains to amphotericin B,itraconazole and caspofungin was between 93.58%and 98.49%.The proportion of wild-type strains of A.flavus and A.niger for amphotericin B,itraconazole,voriconazole,posaconazole and caspofungin were between 92.45%and 100.00%,respectively.The MIC_(50) of A.flavus for amphotericin B was 4μg/ml,and the MIC range was 1~4μg/ml;the range of A.terreus for amphotericin B was 2~4μg/ml.CONCLUSION A.fumigatus was the main species of Aspergillus species in the lower respiratory tract specimens in Guangdong.Triazoles and echinocandins had good antibacterial activity against Aspergillus in vitro.The MIC distribution of amphotericin B was significantly higher.

关 键 词：曲霉菌 菌种分布 药物敏感性 下呼吸道 

分 类 号：R379[医药卫生—病原生物学]