老年患者泌尿系真菌感染菌群分布情况及耐药性  

Bacterial Flora Distribution and Drug Resistance of Urinary Tract Fungal Infection in Elderly Patients

作　　者：蔡存会 CAI Cunhui(Clinical Laboratory,Zhengzhou Traditional Chinese Medicine Bone Injury Hospital,Zhengzhou 450016,China)

机构地区：[1]郑州中医骨伤病医院检验科,河南郑州450016

出　　处：《河南医学研究》2024年第20期3671-3674,共4页Henan Medical Research

摘　　要：目的 分析老年泌尿系真菌感染患者的菌群分布情况及耐药特点,为临床合理用药提供经验指导。方法 对郑州中医骨伤病医院泌尿外科2020年12月至2022年12月从226例老年泌尿系统感染患者中收集的2 563份尿液标本进行分析,尿液标本接种于培养基上进行病原菌培养,根据菌种显色差异鉴定菌种类型并采用全自动细菌培养鉴定仪进一步分析,采用法国梅里埃药敏试剂条进行药敏试验,分析老年患者泌尿系真菌感染的菌群分布情况及耐药特点。结果 2 563份尿液标本中共分离鉴定出7种真菌菌株(252株),真菌检出率为9.83%,其中以白念珠菌、热带念珠菌和光滑念珠菌占比最高,分别为47.62%、23.02%、11.90%。药敏试验结果表明,7种真菌均未检出对5-氟胞嘧啶和两性霉素B的耐药菌株;白念珠菌、热带念珠菌、光滑念珠菌对伊曲康唑的耐药率最高,分别为16.67%、18.97%、26.67%;其次为氟康唑,耐药率分别为15.00%、13.79%、23.33%。226例老年泌尿系真菌感染患者经过针对性抗菌药物治疗后,治愈218例,治疗失败8例,总治愈率为96.46%。结论 老年患者泌尿系真菌感染以白念珠菌、热带念珠菌和光滑念珠菌为主,且上述真菌对伊曲康唑、氟康唑均已出现不同程度的耐药性,未来临床可结合老年患者的药敏试验结果合理选择抗真菌药物。Objective To analyze the bacterial flora distribution and drug resistance characteristics of elderly patients with urinary tract fungal infection,and to provide experience guidance for clinical rational drug use.Methods A total of 2563 urine samples collected from 226 elderly patients with urinary system infection in the Department of Urology of Zhengzhou Traditional Chinese Medicine Bone Injury Hospital from December 2020 to December 2022 were analyzed.The urine samples were inoculated on culture medium for pathogen culture.The bacterial species were identified according to the color difference of the bacterial species and further analyzed by automatic bacterial culture identification instrument.The drug sensitivity test was carried out with French Mérieux drug sensitive reagent strips to analyze the bacterial flora distribution and drug resistance characteristics of urinary fungal infection in elderly patients.Results A total of 7 fungal strains(252 strains)were isolated from 2563 urine samples,and the detection rate of fungi was 9.83%.Candida albicans,Candida tropicalis and Candida glabrata accounted for 47.62%,23.02%and 11.90%,respectively.The results of drug sensitivity test showed that none of the 7 fungi were resistant to 5-fluorocytosine and amphotericin B.The resistance rates of Candida albicans,Candida tropicalis and Candida glabrata to itraconazole were the highest,16.67%,18.97%and 26.67%,respectively.The drug resistance rates of fluconazole were 15.00%,13.79%and 23.33%,respectively.In 226 elderly patients with urinary tract fungal infection,218 cases were cured,8 cases failed,the total cure rate was 96.46%.Conclusion Candida albicans,Candida tropicalis and Candida glabrata are the main urinary fungal infections in elderly patients in this hospital,and these fungi have shown varying degrees of resistance to itraconazole and fluconazole.In future clinical trials,antifungal drugs can be reasonably selected based on the results of drug sensitivity tests in elderly patients.

关 键 词：老年人 泌尿系统 真菌感染 菌群分布 耐药性 

分 类 号：R446.5[医药卫生—诊断学]