深部真菌感染调查及耐药性分析

Survey of hospi al fungi infection and drug resistance

目的了解住院患者真菌感染的临床特点及对药物的敏感情况。方法采用回顾性调查,对2002年8月至2005年8月住院病例中的真菌感染病例进行统计分析。结果3年间住院患者真菌感染536例,占检出病原菌的8.37%。引起深部感染的真菌以白色念珠菌为主,占39.37%;毛霉菌与曲霉菌的感染次之,分别达到16.79%和13.62%。呼吸内科、老年内科和ICU病房住院患者较易发生医院真菌感染。真菌感染的部位以呼吸道最高,其次为泌尿道。真菌对酮康唑、咪康唑和益康唑耐药率相对较高,对5-氟胞嘧啶、两性霉素B、制霉菌素相对敏感。结论医院深部真菌感染主要多发生于年老体弱、免疫功能低下、病情危重和长期使用抗生素的患者,已成为医院感染的主要因素之一。医院感染真菌的耐药性日趋严重,临床应用抗真菌药物尽量参考药敏试验结果。

Objective To study the clinical features and drug susceptibility of inpatients with fungi infection. Methods Hospitalized patients infected with fungi during August 2002 to August 2005 were analyzed by retrospective survey. Results 536 cases of fungi infection occurred in three years. The percentage was 8.37 % in pathogen. The most common fungus was Candida albicans （39.37 % ）, and the next were Mucormycosis（ 16.79 % ） and Aspergillus（13.62 %）. Inpatients in respiratory ward, elder ward and ICU ward were easily infected. The majority of systemic fungi infection was the respiratory tract infection,and the next was the urinary tract infection. Most fungi were resistant to ketoconazole, mionazole andeconazole, and susceptible to 5-fluorocytosine, amphotericin B and nystatin. Conclusions Most of the patients infected by fungi are elderly, hypoimmunity,serious disease and long-term use of broad-spectrum antimicrobial agents. Fungi infection is one of the major hospital infection. Fungi are getting more and more resistant to anti-fungal drugs. Using drugs must consult the result of fungi sensitivity test.