侵袭性酵母菌感染的临床特征及抗生素敏感性分析  

Clinical characteristics and antibiotic sensitivity analysis of the invasive yeast infection

作　　者：王欢 陈素明 李霞 崔恩博 鲍春梅 Wang Huan;Chen Suming;Li Xia;Cui Enbo;Bao Chunmei(Laboratory Department of the Fifth Medical Center of the General Hospital of the People's Liberation Army,Beijing 100039)

机构地区：[1]解放军总医院第五医学中心检验科,北京100039

出　　处：《中国抗生素杂志》2024年第10期1095-1100,共6页Chinese Journal of Antibiotics

基　　金：呼吸道感染病原体多重快速核酸试剂盒(No.SQ2020YFF0404184)。

摘　　要：目的研究侵袭性酵母菌菌种分布,临床特征及对抗真菌药物的敏感性,为临床抗真菌治疗提供依据。方法收集解放军总医院第五医学中心2012—2023年期间分离自无菌部位的酵母菌810株,对感染标本类型、基础疾病和药物敏感性进行回顾性分析。结果810株酵母菌株以白念珠菌为主(53.33%),热带念珠菌和光滑念珠菌的构成比分别为19.26%和12.47%。最常见的侵袭性真菌感染标本类型是腹水(30.00%),其次是中段尿(25.80%)。感染人群以50岁以上的男性患者居多,肝炎肝硬化和恶性肿瘤患者为酵母菌易感人群。白念珠菌对氟康唑和伏立康唑的敏感性为98.84%。近平滑念珠菌对三唑类抗真菌药物敏感性为90.24%~97.56%。热带念珠菌对三唑类抗真菌药物敏感性最低(58.97%~73.72%)。结论侵袭性真菌感染的首要病原菌是白念珠菌,其次是热带念珠菌。白念珠菌、近平滑念珠菌对氟康唑和伏立康唑有较好的药物敏感性;热带念珠菌对三唑类的药物敏感性下降;临床应根据药敏结果合理应用抗真菌药物。Objective To identify the distribution,clinical features,and sensitivity of invasive yeast strains to antifungal drugs and provide the basis for clinical antifungal therapy.Method From 2012 to 2023,810 strains of yeast isolated from sterile sites were collected from the Fifth Medical Center of the People’s Liberation Army General Hospital.Retrospective analysis was conducted on the types of infection specimens,underlying diseases,and drug sensitivity.Results The proportion of Candida albicans among 810 strains reached 53.33%,with the proportion of Candida tropicalis and Candida glabrata being 19.26%and 12.47%,respectively.The most common specimen type of invasive fungal infection was ascites(30.00%),followed by midstream urine(25.80%).The majority of infected individuals were male patients over 50 years old,while patients with liver cirrhosis and malignant tumors were susceptible to yeast infection.The sensitivity of Candida albicans to fluconazole and voriconazole was 98.84%.In addition,Candida parapsilosis had a sensitivity rate of 90.24%~97.84%to triazole.Candida tropicalis showed the lowest sensitivity to triazole(58.97%-73.72%).Conclusion The primary pathogen for invasive fungal infections was Candida albicans,followed by Candida tropicalis.Candida albicans and Candida parapsilosis showed better drug sensitivity to fluconazole and voriconazole.Candida tropicalis had a decreased sensitivity to triazole.The clinical application of antifungal drugs should be rationalized according to the drug sensitivity results.

关 键 词：酵母菌 侵袭性感染 临床特征 抗生素敏感性 

分 类 号：R978[医药卫生—药品]