宁波市某医院真菌血流感染的分布特征及耐药性分析  

Analysis of the distribution characteristics and resistance of fungal blood flow infection in a hospital in Ningbo City

作　　者：葛婷婷 叶鸿雁 王威 乐旭波 张丹丹 GE Tingting;YE Hongyan;WANG Wei;LE Xubo;ZHANG Dandan(Department of Clinical Laboratory,Beilun People's Hospital,Ningbo 315800,China)

机构地区：[1]宁波市北仑区人民医院检验科,浙江宁波315800

出　　处：《健康研究》2025年第1期107-111,共5页Health Research

基　　金：浙江省医药卫生科技计划项目(2024KY353)。

摘　　要：目的了解真菌血流感染的分布特征及耐药情况,为临床治疗提供依据。方法回顾性收集12291例患者的21362份血培养标本,进行菌株鉴定和药敏试验,统计从中分离出的真菌,分析真菌分布特征和药敏试验结果,比较2种常用酵母样真菌药敏试验结果的一致性。结果血流感染中共检出真菌115株,其中念珠菌属占97.4%(112/115),排在前3位的是白色念珠菌39株(33.9%),近平滑念珠菌31株(27.0%)和热带念珠菌29株(25.2%)。检出真菌的血培养标本中66.1%来自男性、48.7%来自60岁以上,来源科室主要为ICU(占40.9%)。白色念珠菌、近平滑念珠菌和热带念珠菌对两性霉素B和5-氟胞嘧啶的敏感性最高,达100%;对唑类药物有不同的耐药性。AST-YS08药敏卡和ATB Fungus 3试剂条的药敏结果一致率较高。结论真菌血流感染的病原菌以念珠菌属为主,对唑类药物的敏感性不高;AST-YS08药敏卡可适用于酵母样真菌的药敏试验。建议临床重视真菌血流感染的预防评估,必要时提高真菌培养的送检率,及早合理使用抗真菌药物。Objective To understand the distribution characteristics and drug resistance of fungal bloodstream infections,providing a basis for clinical treatment.Methods Retrospective collection of 21362 blood culture samples from 12291 patients was conducted,with strain identification and susceptibility testing performed.The fungi isolated were statistically analyzed to determine their distribution characteristics and susceptibility test results,and the consistency of susceptibility test results between two commonly used yeast-like fungi was compared.Results A total of 115 fungal strains were detected in bloodstream infections,with Candida species accounting for 97.4%(112/115).The top three species were Candida albicans with 39 strains(33.9%),Candida parapsilosis with 31 strains(27.0%),and Candida tropicalis with 29 strains(25.2%).Of the blood culture specimens with detected fungi,66.1%were from males,48.7%were from individuals over 60 years old,and the majority were from the ICU(40.9%).Candida albicans,Candida parapsilosis,and Candida tropicalis showed the highest sensitivity to amphotericin B and 5-fluorocytosine,reaching 100%;they exhibited varying degrees of resistance to azole drugs.The AST-YS08 susceptibility card and the ATB Fungus 3 strip showed a high consistency in susceptibility results.Conclusions The pathogens of fungal bloodstream infections are mainly Candida species,with low sensitivity to azole drugs;the AST-YS08 susceptibility card is suitable for susceptibility testing of yeast-like fungi.It is recommended that the clinical community pay attention to the prevention and assessment of fungal bloodstream infections,increase the rate of fungal culture submission when necessary,and use antifungal drugs rationally and early.

关 键 词：血流感染 真菌 念珠菌 真菌药敏试验 AST-YS08 

分 类 号：R379[医药卫生—病原生物学]