232株热带念珠菌感染的临床特点及菌株耐药性分析  

Clinical characteristics and drug resistance analysis of 232 cases of Candida tropicalis infections

作　　者：赵旭初 胡爱玲 王东[1] 衡媛[1] 王娜[1] ZHAO Xuchu;HU Ailing;WANG Dong;HENG Yuan;WANG Na(First Hospital of Qinhuangdao,Qinhuangdao 066000,China)

机构地区：[1]秦皇岛市第一医院药学部,秦皇岛066000

出　　处：《中国真菌学杂志》2022年第6期472-475,489,共5页Chinese Journal of Mycology

基　　金：秦皇岛市科学技术研究与发展计划项目(202101A164)。

摘　　要：目的 研究与分析我院热带念珠菌的临床分布及耐药性特点等,为临床预防和治疗热带念珠菌感染提供参考依据。方法 回顾性分析2018年1月—2021年12月间秦皇岛市第一医院分离出热带念珠菌的患者的临床资料。结果 共收集到热带念珠菌232株,其标本来源主要为尿液标本(134株占57.8%),其中男性156例,女性76例,平均年龄为(68.5±16.5)岁。科室来源主要为ICU (102株)、呼吸内科(39株)、肾脏内科(14株),这前3位科室占热带念珠菌总株数的66.8%。药敏试验结果表明,分离出的热带念珠菌菌株对5-氟胞嘧啶和两性霉素B完全敏感,对氟康唑、伊曲康唑和伏立康唑的耐药率均较高,分别为41.3%、44.9%和42.7%,对伊曲康唑的敏感率最低为30.7%。且对伏立康唑的耐药性在外科病房和ICU表现得最为显著。从对临床常用抗生素耐药性变化趋势的统计发现,2018年—2020年热带念珠菌对氟康唑、伊曲康唑和伏立康唑的耐药率一直很高,2021年耐药率显著降低。结论 我院的热带念珠菌耐药现象从2021年开始有明显好转,这与医院加强临床科室对抗生素使用的管控密切相关,因此为减少或延缓耐药菌株的出现,防止耐药菌感染的爆发,应继续加强管控力度。Objective To study and analyze the clinical distribution and drug resistance characteristics of Candida tropicalis in our hospital,and to provide reference for clinical prevention and treatment of C.tropicalis infection.Methods The clinical data of patients with C.tropicalis infection in the first hospital of Qinhuangdao from January 2018 to December 2021 were analyzed retrospectively.Results A total of 232 strains of C.tropicalis were collected,and the samples were mainly urine samples(134 strains,accounting for 57.8%),including 156 males and 76 females,with an average age of 68.5±16.5 years;The main sources of departments were intensive care units(102 strains),respiratory department(39 strains)and nephrology department(14 strains).And the Candida tropicalis infection in the top three departments accounted for 66.8%;The results of drug sensitivity test showed that the isolated Candida tropicalis strains were completely sensitive to 5-fluorocytosine and amphotericin B.The resistance rates to fluconazole,itraconazole and voriconazole were 41.3%,44.9% and 42.7% respectively,and the sensitivity rate to itraconazole was the lowest,30.7%.And resistance to voriconazole was most pronounced in surgical wards and intensive care units.According to the statistics on the change trend of drug resistance of commonly used antibiotics in clinic,the drug resistance rates of C.tropicalis to fluconazole,itraconazole and voriconazole had been very high from 2018 to 2020,and the drug resistance rate decreased significantly in 2021.Conclusion The drug resistance of C.tropicalis in our hospital has improved significantly from 2021,which is closely related to the strengthening of the control of antibiotic use in clinical departments.Therefore,in order to reduce or delay the emergence of drug-resistant strains and prevent the outbreak of drug-resistant fungal infection.We should continue to strengthen the control.

关 键 词：热带念珠菌 耐药性 药敏试验 

分 类 号：R379.4[医药卫生—病原生物学]