真菌感染肿瘤患者酵母样真菌的分离鉴定及药敏结果分析

Isolation,identification and drug susceptibility test of yeast-like fungi in tumor patients associated with fungous infections

目的研究中原油田总医院并发真菌感染肿瘤患者酵母样真菌的感染现状及耐药情况。方法各种临床标本经分离培养,由VITEK32-YBC卡进行酵母样真菌鉴定,分纯菌株采用纸片扩散法对5种抗真菌药物进行药敏试验。结果352份并发真菌感染肿瘤患者的各类标本中有63份分离出酵母样真菌,阳性率为17.9%。分离出菌株66株,其中有3份痰标本分别同时分离出两株真菌。检出率以痰液最高为69.7%,其次咽拭子为13.6%,真菌种类以白色假丝酵母菌和热带假丝酵母菌为主,分别为56.1%和18.2%。分离菌株对制霉菌素、两性霉素B、伊曲康唑的敏感率较高,分别为100%,97%,90.9%。对氟康唑、克霉唑的中介度和耐药率较高,分别为12.1%,6.1%和10.6%,15.2%。结论临床微生物实验室应加强真菌的分离培养和药敏试验,指导临床合理选择抗真菌药物,以减少真菌引起的医院感染。

Objective To study the characteristics of yeast-like fungi infection and antifungal resistance in tumor patients associated with fungous infections. Methods Yeast-like fungi isolated from clinical samples were cultured and identified with VITEK32 - YBC card. Antifungal agent sensitivity test was detected by disk diffusion test. Results A total of 63 samples of yeast-like fungi were isolated from 352 samples of tumor patients associated with fungous infections. The isolation rate was 17.9 %. Two strains of fungi were contained simultaneously in 3 samples . The isolation rate of yeast-like fungi isolated from sputum was highest（69.7% ）. The second was pharynx（ 13.6 % ）. Of the 66 strains of fungi, the first was Candida albicans （56.1% ） and the second was C. tropicalis （ 18.2 % ）. The separated fungi were sensitive to nystatin（ 100 % ）, amphoteriein B（97 % ）, itraeonazole（90.9 % ）, and intermedi- ate and resistant to flueonazole（ 12.1%, 6.1% ）, elotrimazole（ 10.6 %, 15.2 % ）. Conclusion To guide clinically the selection of reasonable antifungal agents and reduce hospital fungal infection, the isolation and identification of yeast-like fungi should be carried out eorrecdy, and the drug susceptibility test should be done in laboratory of clinical microbiology.