临床常见真菌分离菌株的种类、分布及其耐药性分析  

Analysis of common fungal infections and drug resistance

作　　者：龚晓雪 马迁 俞迪 施家成 GONG Xiaoxue;MA Qian;YU Di;SHI Jiacheng(Shanghai Dian Medical Laboratory Co.,Ltd,Shanghai 200433,China)

机构地区：[1]上海迪安医学检验所有限公司,上海200433

出　　处：《中国真菌学杂志》2024年第2期138-142,共5页Chinese Journal of Mycology

摘　　要：目的分析上海迪安医学检验所有限公司临床送检体液样本中真菌感染的种类、临床样本来源分布及其耐药性情况,为后续真菌感染类型及其耐药性的现状、治疗策略和发展趋势等提供参考依据。方法收集2023年1月至2023年7月的临床体液样本2681份进行真菌培养,对分离到的823株真菌进行菌种分布和药敏情况进行分析。结果发现构成比最高的前5种菌种分别为白念珠菌(n=355)、光滑念珠菌(n=212)、热带念珠菌(n=105)、近平滑念珠菌(n=69)、拟平滑念珠菌(n=36)。其中白念珠菌的构成比为43.1%,占据了所有分离到的真菌近一半。其次是光滑念珠菌的构成比为25.8%,热带念珠菌和近平滑念珠菌的构成比分别为12.8%和8.4%,而构成比前3位的体液类型为尿液(44.8%)、痰液(26.7%)、血液(12.4%)。分别测试了823株菌对5-氟胞嘧啶、伏立康唑、氟康唑、两性霉素-B、伊曲康唑的敏感性,这些菌株对两性霉素B综合敏感性达到了98.5%,除阿萨希毛孢子菌外,其余菌株对两性霉素B均没有耐药情况。同时,这些菌株对5-氟胞嘧啶的综合敏感性达到了97.3%,对伏立康唑、氟康唑和伊曲康唑的综合敏感性分别为92.8%、63.1%和62.3%。结论本研究结果主要为念珠菌属,其中又以白念珠菌为主,这些菌种对两性霉素B和5-氟胞嘧啶的敏感性均较好,而热带念珠菌对氟康唑、伏立康唑和伊曲康唑的耐药率均较高,达到30%以上。Objective To analyze the types of fungal infections,distribution of clinical sample sources,and drug resistance in body fluid samples submitted by Shanghai Dian Medical Laboratory Co.,Ltd,in order to provide reference for the current status,influencing factors,treatment strategies,and development trends of fungal infections and drug resistance in the future.Method Collect 2681 clinical body fluid samples from January 2023 to July 2023 for cultivation,and analyze the bacterial distribution and drug sensitivity of 823 isolated fungi.Result The top five strains with the highest composition ratio were found to be Candida albicans(n=355),Candida glabrata(n=212),Candida tropicalis(n=105),Candida parapsilosis(n=69),and Candida orthopsilosis(n=36).The composition ratio of Candida albicans is 43.1%,accounting for nearly half of all isolated fungal specimens.Secondly,the composition ratio of Candida glabrata is 25.8%,while the composition ratios of Candida tropicalis and Candida parapsilosis are 12.8%and 8.4%,respectively.The top three types of body fluids in the composition ratio are urine(44.8%),sputum(26.7%),and blood(12.4%).The sensitivity of 823 strains of fungi to 5-fluorocytosine,voriconazole,fluconazole,amphotericin-B,and itraconazole was tested,and these strains achieved a combined susceptibility to amphotericin-B of 98.5%,and none of the strains were resistant to amphotericin-B,except for Trichosporon asahii.At the same time,the sensitivity of these strains to 5-fluorocytosine reached 97.3%,and the sensitivity to voriconazole,fluconazole,and itraconazole was 92.8%,63.1%,and 62.3%,respectively.Conclusion The main cause of infection is Candida spp.,which is mainly Candida albicans.These strains have good sensitivity to 5-fluorocytosine,while Candida tropicalis has a high resistance rate to fluconazole,voriconazole,and itraconazole,with a rate of over 30%.

关 键 词：真菌 体液感染 耐药性分析 

分 类 号：R519[医药卫生—内科学]