我院近5年深部真菌感染与耐药现状调查

The investigation of deep fungus infection and antifungal resistance in our hospital during recent 5 years

目的了解近5年来真菌感染及其耐药情况。方法收集5年来临床分离的真菌219株,对常见菌株进行5种抗真菌药物的体外敏感试验。结果临床真菌感染部位以呼吸道感染居多,为146株,其次来自泌尿道37株,肠道27株,口咽部6株,血液2株,脑脊液1株。菌种分布以白色念珠菌最多,占54.8%;其次为热带念珠菌,占15.5%,光滑念珠菌,占11.0%;其他真菌分离率均(10.0%。对5种常用抗真菌药进行耐药分析显示氟胞嘧啶、两性霉素B对念珠菌相对3种唑类药物分别具有较低的耐药率(P(0.01)。克柔念珠菌对氟康唑和酮康唑的耐药菌株均占到30%以上,是耐药性较强的念珠菌。结论深部真菌感染及耐药性呈逐年上升趋势,唑类抗真菌药物已呈明显耐药,采用有效防治措施刻不容缓。

Objective To moniter fungus infection and antifungsls resistance in our hospital during recent 5 years. Methods Two hundreds and nineteen strains of fungi were isolated from inpatients of our hospital in recent 5 years. The susceptibility testing in vitro to 5 antifungal drugs were evaluated . Results The respiratory infection was the most predominant of elinieal fungi infection for 146 isolates; the second was from urinarty, intestinal, orpharynx,blood, csf ：37,27,6,2,1 respectively. The first three pathogenic fungi were C. albicans （54. 8% ）, C. tropicalls （ 15.5% ）,Torulopsis glabrata （ 11.0% ）, and the other fungi separated rate were all lower than 10%. The resistance of fungi to 5 antifungul agents were tested. Flueytosine（5-FC） and amphoteriein B（AMB） had the lower drug-resistance rate than that of 3 azoles drugs（P 〈 0. 01 ）. Among Candida,the reslstanee rate of C. parapsilosis to flueonazole and ketoconazole were larger than 30%. Conclusions It is importan to pay attention to that deep fungus infection and drug-resistance rate had raised for years and azoles antifungsl agents had drug-reslstance rate significantly.