江西某三甲医院2013—2022年临床无菌体液标本分离的酵母菌分布及对抗真菌药物敏感性特点  

Distribution and antifungal drug sensitivity of yeasts isolated from a Grade A tertiary hospital in Jiangxi Province from 2013 to 2022

作　　者：邓林强[1] 陈益国[1] 陈会[1] 杜宇娜 Deng Linqiang;Chen Yiguo;Chen Hui;Du Yuna(Department of Laboratory Medicine,Jiangxi Provincial People’s Hospital,the First Affiliated Hospital of Nanchang Medical College,Nanchang 330006)

机构地区：[1]江西省人民医院(南昌医学院第一附属医院)检验科,南昌330006

出　　处：《中国抗生素杂志》2024年第10期1168-1174,共7页Chinese Journal of Antibiotics

摘　　要：目的了解江西某三甲医院无菌体液中酵母菌分布及抗真菌药物敏感性,为临床的预防与治疗提供参考依据。方法采用回顾性分析,对2013—2022年无菌体液标本分离出酵母菌的分布和对5种抗真菌药物敏感性进行分析。结果①从临床无菌体液标本中共分离出1028株酵母菌,以念珠菌属为主(95.2%),白念珠菌分离出398株(38.7%),近平滑念珠菌有239株(23.2%),其他酵母菌如新型隐球菌45株(4.4%),菌株分布比较存在显著性差异(P<0.001)。②1028例分离出酵母菌的患者中,年龄以18~<65岁为主(53.1%),年龄段人员分布比较存在显著性差异(P<0.05);标本分离率最高的是血液标本(41.1%),其次是尿液标本(12.6%),标本分布存在显著性差异(P<0.001);标本来源病区,重症监护病区患者总分离率占比较高(40.5%),门诊分布较少(1.2%),病区分布比较存在显著差异(P<0.001)。③1028株酵母菌中,近平滑念珠菌对两性霉素B的非野生型菌株占比为32.2%,高于白念珠菌、热带念珠菌和光滑念珠菌占比(均在10%以下);对伊曲康唑的非野生型菌株占比为6.3%,低于光滑念珠菌(37.0%)和热带念珠菌(60.9%)的占比;对伏立康唑和氟康唑的敏感率(分别为76.2%和88.7%)也高于白念珠菌和热带念珠菌。新型隐球菌对5种抗真菌药物的非野生型菌株占比为2.2%~20%。结论某院2013—2022年无菌体液标本分离出的酵母菌在菌株、患者年龄、病区和标本种类分布存在差异。不同的酵母菌对抗真菌类药物的敏感性不同,在治疗其感染时需结合体外药敏试验结果合理选择抗真菌药物。Objective To investigate the distribution and fungicide sensitivity of yeasts in the aseptic body fluid of a Grade A tertiary hospital in Jiangxi Province,so as to provide a reference for clinical prevention and treatment.Methods Retrospective analysis was used to compare the distribution of yeasts isolated from sterile body fluid and the characteristics of the sensitivity changes of 5 kinds of fungicides from 2013 to 2022.Results①A total of 1028 strains of yeasts were isolated,Candida spp.was the most common(95.2%).C.albicans was isolated with 398 strains(38.7%),followed by 239 strains(23.2%)of C.parapsilosis and 45 strains(4.4%)of C.neoformans.There was a significant difference in the distribution(P<0.001).②The patients were mainly aged 18~<65 years(53.1%),and there was a significant difference in the age distribution(P<0.05).The highest sample separation rate was observed in blood samples(41.1%),followed by urine samples(12.6%),with significant differences in sample distribution(P<0.001).Among different wards,the total separation rate of patients in the intensive care unit was relatively high(40.5%),while the distribution of patients in the outpatient department was relatively low(1.2%).There was a significant difference in the distribution of disease areas(P<0.001).③Among the 1028 strans of yeasts,32.2%of C.parapsilosis were non-wild-type(non-WT)to amphotericin B,higher than that of C.albicans,C.tropicalis and C.glabrata(all less than 10%of the non-WT strains).6.3%of C.parapsilosis were non-WT to itraconazole,lower than that of C.glabrata and C.tropicalis(37.0%and 60.9%).The susceptibility rates of voriconazole and fluconazole to C.parapsilosis(76.2%and 88.7%)were also higher than those of C.albicans and C.tropicalis.2.2%~20%of C.neoformans were non-WT to 5 antifungal drugs.Conclusion There were differences among the strains,age of patients,ward and specimen type of yeasts isolated from aseptic body fluid samples in a hospital during from 2013 to 2022.Different yeasts had different sensitivity to antifu

关 键 词：无菌体液标本 酵母菌 抗真菌类药物 念珠菌属 非野生株 敏感率 

分 类 号：R978.1[医药卫生—药品]