2019—2021年四川省血流感染病原真菌分布特征及药敏分析  

Pathogenic distribution characteristics of fungal bloodstream infection in Sichuan Province from 2019 to 2021

作　　者：邓劲[1] 殷琳[2] 江海燕 旷凌寒[4] 彭溪[5] 杨向贵 倪苏娇 张帮勤 冯金芳 王燕玲[10] 马瑜珊[11] 陈宗耀[12] 钟涵宇 吴贤丽 黎昆[15] 王玲[16] 高伟 杨学强[18] 朱军[19] 陈喻[20] 张弦 孙昌君[22] 罗军[23] 李玉梅[24] 李彦 张兵 谢宁[27] 王俊[28] 谢轶[1] 康梅[1] DENG Jin;YIN Lin;JIANG Haiyan;KUANG Linghan;PENG Xi;YANG Xianggui;NI Sujiao;ZHANG Bangqin;FENG Jinfang;WANG Yanling;MA Yushan;CHEN Zongyao;ZHONG Hanyu;WU Xianli;LI Kun;WANG Ling;GAO Wei;YANG Xueqiang;ZHU Jun;CHEN Yu;ZHANG Xian;SUN Changjun;LUO Jun;LI Yumei;LI Yan;ZHANG Bin;XIE Ning;WANG Jun;XIE Yi;KANG Mei(Department of Laboratory Medicine,West China Hospital,Sichuan University,Chengdu 610000;Sichuan Provincial People’s Hospital,Chengdu 610000;Guang’an People’s Hospital,Guang’an 638500;West China Second Hospital of Sichuan University,Chengdu 610000;Chengdu Third People’s Hospital,Chengdu 610000;The First Affiliated Hospital of Chengdu Medical College,Chengdu 610000;Sichuan Cancer Hospital,Chengdu 610000;Affiliated Hospital of Southwest Medical University,Luzhou 646000;Guangyuan Central Hospital,Guangyuan 628000;Leshan People's Hospital,Leshan 614000;Mianyang Third People's Hospital,Mianyang 621000;Deyang City People's Hospital,Deyang 618000;Neijiang First People's Hospital,Neijiang 641000;Panzhihua Central Hospital,Panzhihua 617000;Suining Central Hospital,Suining 629000;Xichang Municipal People's Hospital,Xichang 615000;Ya'an Municipal People's Hospital,Ya'an 625000;Yibin Second People's Hospital,Yibin 644000;Ziyang First People's Hospital,Ziyang 641300;Zigong First People's Hospital,Zigong 643000;Chengdu Second People's Hospital,Chengdu 610000;Dazhou Central Hospital,Dazhou 635000;Mianyang Central Hospital,Mianyang 621000;Zigong Fourth People's Hospital,Zigong 643000;Meishan People's Hospital,Meishan 620000;Nanchong City Central Hospital,Nanchong 637000;Affiliated Hospital of North Sichuan Medical College,Nanchong 637000;Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine,Panzhihua 617000)

机构地区：[1]四川大学华西医院实验医学科(检验科),成都610000 [2]四川省医学科学院·四川省人民医院,成都610000 [3]广安市人民医院,广安638500 [4]四川大学华西第二医院,成都610000 [5]成都市第三人民医院,成都610000 [6]成都医学院第一附属医院,成都610000 [7]四川省肿瘤医院,成都610000 [8]西南医科大学附属医院,泸州646000 [9]广元市中心医院,广元628000 [10]乐山市人民医院,乐山614000 [11]绵阳市第三人民医院,绵阳621000 [12]德阳市人民医院,德阳618000 [13]内江市第一人民医院,内江641000 [14]攀枝花市中心医院,攀枝花617000 [15]遂宁市中心医院,遂宁629000 [16]西昌市人民医院,西昌615000 [17]雅安市人民医院,雅安625000 [18]宜宾市第二人民医院,宜宾644000 [19]资阳市第一人民医院,资阳641300 [20]自贡市第一人民医院,自贡643000 [21]成都市第二人民医院,成都610000 [22]达州市中心医院,达州635000 [23]绵阳市中心医院,绵阳621000 [24]自贡市第四人民医院,自贡643000 [25]眉山市人民医院,眉山620000 [26]南充市中心医院,南充637000 [27]川北医学院附属医院,南充637000 [28]攀枝花市中西医结合医院,攀枝花617000

出　　处：《中国真菌学杂志》2023年第3期198-204,210,共8页Chinese Journal of Mycology

摘　　要：目的收集全国真菌病监测网四川省中心真菌血流感染数据,整理分析病原菌分布特点及抗真菌药物敏感性情况,为四川省真菌血流感染提供流行病学数据。方法研究28家医院2019年1月1日—2021年12月31日门急诊及住院患者真菌血流感染的数据,采用Whonet 5.6及Microsoft Excle数据透视表功能分析真菌血流感染的临床资料及实验室信息。结果2019年1月1日—2021年12月31日28家医院上报数据中的1220株真菌中,念珠菌属占88.8%(1083/1220),以白念珠菌为主,占35.3%(431/1220);新生隐球菌位于总分离株数的第5位,占8.3%(101/1220)。男性占比56.6%(690/1220),女性患者相比较少(43.4%,530/1220);其中中老年患者(>46岁)79.8%,34.8%来自于重症监护室。白念珠菌对氟康唑的敏感性最高(85.7%);热带念珠菌对氟康唑和伏立康唑的耐药率分别为43.4%和43.3%,且逐年上升。分离的101株新生隐球菌对两性霉素B、氟胞嘧啶、氟康唑、伏立康唑和伊曲康唑均存在不同的非野生株,比例分别为5.0%、2.5%、11.8%、5.7%和8.5%;每家医院分离病原菌的数量排序存在一定差异,大多数医院以白念珠菌为主,但儿童专科性医院近平滑念珠菌分离数最多。结论真菌血流感染病原菌及其抗真菌药物敏感性存在地域性特点,准确掌握所在地区病原菌流行病学资料可以为临床选择抗真菌药物提供依据。Objective To collect the fungal bloodstream infection data from the Sichuan Provincial Center of China Fungal Disease Surveillance System,to analyze the distribution characteristics and the susceptibility to antifungal drugs of pathogens,and to provide epidemiological data for fungal bloodstream infections in Sichuan Province.Methods The data of outpatient,emergency,and inpatient fungal bloodstream infections in 28 hospitals from January 1,2019,to December 31,2021,were studied.The clinical and laboratory data of fungal bloodstream infection were analyzed using Whonet 5.6 and Microsoft Excle pivot table.information.Results From January 1,2019,to December 31,2021,Candida accounted for 88.8%(1083/1220)of the 1220 fungal strains was reported by 28 hospitals.Candida albicans was the main species,accounting for 35.3%(431/1220).and Cryptococcus neoformans being fifth in the total number of isolates,accounting for 8.3%(101/1220).Males accounted for 56.6%(690/1220),and female patients were less(43.4%,530/1220);79.8%cases were middle-aged and elderly patients(>46 years old)and 34.8%cases were from the intensive care unit.C.albicans had the highest sensitivity to fluconazole(85.7%);resistance rates of C.tropicalis to fluconazole and voriconazole were 43.4%and 43.3%,respectively.by C.albicans isolates were dominated in Most hospitals,however,C.parapsilosis was mostly isolated in children's specialized hospitals.Conclusion The pathogens of fungal bloodstream infection and their antifungal drug susceptibility have regional characteristics.Accurately grasping the epidemiological data in the region can provide a basis for the clinical selection of antifungal drugs.

关 键 词：真菌血流感染 病原菌 抗真菌药物敏感性 分布特征 流行病学 

分 类 号：R519[医药卫生—内科学]