医院感染患者真菌的分离及耐药性探讨

Study on drug resistance of fungi isolated from infected patients in hospital

目的 :分析452例感染患者真菌分离鉴定和药敏试验结果 ,了解酵母样真菌耐药性的变化趋势。方法 :选择沙保弱培养基上菌落用YBC或API20CAUX做菌种鉴定 ,用微量肉汤稀释法 (MIC)进行药敏试验。结果 :真菌感染中以白色念珠菌感染为主 ,占81.86 %。真菌对氟康唑 ,两性霉素B ,5-氟胞嘧啶 ,酮康唑保持较高体外抗真菌活性 ,敏感率分别为98.0% ,96.2 % ,94.7 %和90.7 %。对制霉菌素 ,特比萘芬耐药率为92.50% ,90.70 %。对伊曲康唑敏感率仅为47.10%。结论 :真菌感染中以白色念珠菌为主 ,免疫力低下可能是引起真菌感染的主要原因 ,氟康唑 ,两性霉素B ,5-氟胞嘧啶仍保持较高抗真菌活性 ,是治疗真菌感染的有效药物 ,对于合理使用抗菌药物 ,减少真菌感染 ,特别是耐药菌株感染的发生有着重要的意义。

Objective: To analyze the results of fungi identification and drug sensitive test of 452 fungi isolated from clinical infected patients and to know the resistance to antifungi drugs.Methods:The colony which growed in the sabourand's agar culture medium was chosen to identify the fungi by YBC or API20C AUX and drug sensitive test was performed by MIC.Results:The incidence of Candida albicans infection was the highest(81.86%).The separated fungi were relatively sensitive to fluconazole (98.0%),amphotericin B(96.2%),5-fluorocytosine (94.7%), ketonazole(90.7%),itracoinazole(47.10%)and resistant to nystatin (92.50%),terbinafin (90.70%).Conclusion:C.albican is still the essential strain in fungus infection . Hypoimmunity may be a main cause of fungus infection, fluconazole,amphotericin B, 5-fluorocytosine are effective in therapy of fungus infection,anti-fungal medicine can use reasonably according to the result of drug sensitive test so that the incidence of fungal infection,especially fungi-resistant infection may be reduce.