785例念珠菌感染的菌种分布及感染特征  

Species Distribution and Epidemiological Characteristics of Candidiasis in 785 Cases

作　　者：应利娟 魏丹丹[1,2,3] 梅艳芳[3] 应颖 熊小建 YING Li-juan;WEI Dan-dan;MEI Yan-fang;YING Ying;XIONG Xiao-jian(Jiangxi Medical Center for Critical Public Health Events,the First Affiliated Hospital of Nanchang University,Nanchang 330052,China;Jiangxi Provincial Key Laboratory for Infectious Disease Prevention and Control,the First Affiliated Hospital of Nanchang University,Nanchang 330052,China;Department of Laboratory Medicine,the First Affiliated Hospital of Nanchang University,Nanchang 330052,China;Colposcopy Room,Outpatient Department,People’s Hospital of Guixi City General Hospital,Yingtan 335400,China)

机构地区：[1]南昌大学第一附属医院江西省重大公共卫生事件医学中心,南昌330052 [2]南昌大学第一附属医院传染病防治江西省重点实验室,南昌330052 [3]南昌大学第一附属医院检验中心,南昌330052 [4]贵溪市总医院人民分院院区门诊阴道镜室,江西鹰潭335400

出　　处：《实用临床医学(江西)》2025年第1期1-5,10,共6页Practical Clinical Medicine

基　　金：江西省自然青年科学基金项目(20142BAB215053);江西省教育厅科技项目(GJJ12160)。

摘　　要：目的 分析南昌大学第一附属医院念珠菌感染患者的菌种分布和感染特征。方法 收集该院在2020年7月至2024年4月785例念珠菌感染患者的资料,对其性别、年龄、科室来源、标本类型、菌种分布等信息进行统计分析。结果 共收集到1355株念珠菌,其中995株(73.4%)为致病菌,男、女性患者分别占62%(617/995)和38%(378/995),感染比例整体随年龄增长而增加,51~80岁患者居多,占比68.1%(678/995)。来源于重症监护室(ICU)的菌株占首位,占比43.2%(430/995);其次是普外科18.7%(186/995)和急诊科10.5%(104/995)。血液标本(43.3%)和胸腹水标本(25.5%)分别列于前两位。菌种分布上,白色念珠菌占45.7%(455/995),其次为近平滑念珠菌群23.3%(232/995)和热带念珠菌19.8%(197/995)。455株白色念珠菌中,痰/粪便标本、胸腹水和引流液/脓液中检出率居前三位,分别占64.7%(11/17)、63.4%(161/254)和57.6%(49/85);在骨科、普外科和消化内科中检出率居前三位,分别占67.6%(25/37)、62.9%(117/186)和57.6%(19/33)。232株近平滑念珠菌群在导管尖端、血液和分泌物中检出率较高,分别占40.0%(26/65)、32.9%(142/431)和29.7%(11/37);在肾内科和ICU中检出率居前,分别占52.4%(22/42)和32.1%(138/430)。197株热带念珠菌在血液科和尿液中检出率最高,分别占70.0%(28/40)和84.6%(11/13)。结论 念珠菌感染男性患者多于女性,且51~80岁患者占比较高。菌株大多来源于ICU、普外科和急诊科。标本类型主要来源于血液和胸腹水。白色念珠菌仍然是居首位的临床致病念珠菌。然而非白念珠菌感染亦呈上升趋势,是导致血液、导管尖端、分泌物和尿道中真菌感染的主要原因。Objective To analyze the species distribution and epidemiological characteristics of Candida infections among patients at the First Affiliated Hospital of Nanchang University.Methods Clinical data from 785 patients with candidiasis admitted between July 2020 and April 2024 were collected,including gender,age,department origin,specimen types,and fungal species distribution.Results A total of 1355 Candida isolates were collected,of which 995(73.4%)were identified as pathogenic strains.Male patients predominated(62.0%,617/995)over females(38.0%,378/995),with infection prevalence demonstrating an ascending pattern correlating with advancing age,peaking in the 51–80 year age cohort(68.1%,678/995).Strains originating from the Intensive Care Unit(ICU)constituted the predominant proportion(43.2%,430/995),followed by those from General Surgery(18.7%,186/995)and Emergency Department(10.5%,104/995).Blood specimens(43.3%)and pleural/ascitic fluid specimens(25.5%)represented the two most frequent sample sources.In terms of species distribution,Candida albicans predominated(45.7%,455/995),followed by the Candida parapsilosis complex(23.3%,232/995)and Candida tropicalis(19.8%,197/995).Among the 455 C.albicans isolates,the highest detection rates were observed in sputum/stool specimens(64.7%,11/17),pleural/ascitic fluid(63.4%,161/254),and drainage/pus specimens(57.6%,49/85),while departmental analysis revealed elevated prevalence in Orthopedics(67.6%,25/37),General Surgery(62.9%,117/186),and Gastroenterology(57.6%,19/33).Among the 232 Candida parapsilosis complex isolates,higher detection rates were observed in catheter tips(40.0%,26/65),blood specimens(32.9%,142/431),and secretions(29.7%,11/37),with particularly notable prevalence rates in Nephrology(52.4%,22/42)and Intensive Care Unit(32.1%,138/430).For the 197 Candida tropicalis isolates,the highest detection rates were documented in Hematology Department(70.0%,28/40)and urine specimens(84.6%,11/13).Conclusion Candidiasis demonstrated male predominance and higher prevalence

关 键 词：念珠菌 菌种分布 白色念珠菌 感染特征 

分 类 号：R519.3[医药卫生—内科学]