广东省2019—2021年血培养分离真菌的菌种分布及药敏分析  

Species distribution and antifungal susceptibility of fungi originating from positive blood cultures in Guangdong,2019-2021

作　　者：彭雅琴 廖康[1] 伍众文[1] 郭鹏豪[1] PENG Ya-qin;LIAO Kang;WU Zhong-wen;GUO Peng-hao(Department of Clinical Laboratory,the First Affiliated Hospital of Sun Yat-Sen University,Guangzhou,Guangdong 510080,China)

机构地区：[1]中山大学附属第一医院检验科,广东广州510080

出　　处：《中国热带医学》2023年第3期277-282,共6页China Tropical Medicine

摘　　要：目的了解广东地区血培养标本中真菌的菌种分布及药物敏感性特征,为临床真菌血流感染合理使用抗真菌药物提供依据。方法对2019年1月—2021年12月广东省真菌病监测网监测单位上报数据中血培养标本分离真菌的患者临床资料、菌种分布及药物敏感性结果进行回顾性分析。结果2019—2021年广东省共分离真菌3589株,以念珠菌属为主(86.5%,3105/3589)。构成比排前3位的菌株分别是白念珠菌(36.6%,1315/3589)、热带念珠菌(17.4%,626/3589)及近平滑念珠菌(14.5%,520/3589)。菌株的科室来源以ICU最多,占42.1%(1512/3589)。其中ICU、普通外科、器官移植科及急诊科中白念珠菌的构成比为40.0%~50.0%。血液内科以热带念珠菌为主(60.0%,144/240),感染科以新型隐球菌(35.4%,69/195)和马尔尼菲篮状菌(35.9%,70/195)为主。药敏结果显示,未发现两性霉素B非野生型的念珠菌菌株;常见念珠菌对于卡泊芬净、米卡芬净的耐药率为0.0~4.2%。热带念珠菌对于氟康唑、伏立康唑的耐药率为42.3%、38.9%,显著高于其他常见的念珠菌。未发现新型隐球菌氟康唑、伏立康唑非野生型菌株。结论广东地区血培养标本分离真菌以白念珠菌为主。常见念珠菌对于棘白菌素类和两性霉素B具有较高的敏感性;热带念珠菌对于三唑类药物具有较高的耐药率。Objective To investigate the species distribution and the antifungal susceptibility of fungi originating from positive blood cultures in Guangdong,so as to provide a basis for the rational use of antifungal drugs in clinical fungal bloodstream infections.Methods All data were collected for retrospective study from monitoring units of the Guangdong Fungal Disease Surveillance Network between 2019-2021,including clinical characteristics,species distribution and antifungal susceptibility.Results A total of 3589 fungi strains were isolated,most of which were Candida spp.(86.5%,3105/3589).The most common species was Candida albicans(36.6%,1315/3589),followed by Candida tropicalis(17.4%,1626/3589)and Candida parapsilosis(14.5%,520/3589).There were 42.1%(1512/3589)of strains isolated from ICU.The proportions of Candida albicans strains were 40.0%-50.0%among ICU,general surgery,organ transplantation and emergency department.Candida tropicalis(60.0%,144/240)was the most common species in hematology department.Both Cryptococcus neoformans(35.4%,69/195)and Talaromyces marneffei(35.9%,70/195)were common in infection department.All of the Candida isolates were of wild-type(WT)phenotype to amphotericin B.Resistance rates of caspofungin and micafungin for Candida spp.ranged from 0.0%to 4.2%.The resistance rates of Candida tropicalis to fluconazole and voriconazole were 42.3%and 38.9%,which were significantly higher than other common Candida spp.The cryptococcus neoformans strains were totally of WT phenotype to fluconazole and voriconazole.Conclusions Candida albicans is the most common species originating from positive blood cultures in Guangdong Province.Common Candida strains are highly sensitive to echinocandins and amphotericin B.Candida tropicalis has a high resistance rate to triazole drugs.

关 键 词：真菌 血培养 菌种分布 药物敏感性 广东省 

分 类 号：R446.11[医药卫生—诊断学]