146例医院真菌感染的特点及其耐药分析

Characteristics of Nosocomial Drug-Resistant Fungal Infection

目的探讨146例传染病患者医院真菌感染的特点及药敏情况。方法对2003-2005年传染病住院患者中的真菌感染病例进行回顾性调查分析。结果医院真菌感染率从2003的1.16%上升到2005年的1.62%。感染的部位以消化道、口腔为主,分别占39.04%、32.88%。被检出真菌有19种,以白色假丝酵母菌、热带假丝酵母菌为主,分别占37.67%、26.71%,对抗真菌药物伊曲康唑、两性霉素B、氟康唑敏感,但敏感率在下降,对咪康唑、益康唑、酮康唑耐药率较高。感染的发生与病情危重、免疫功能紊乱、老龄化、使用广谱抗菌药物,以及各种侵入性诊疗技术等因素相关。结论真菌感染率呈逐年上升趋势,真菌的耐药性也逐渐增多。对各种危险因素采取综合措施,合理使用抗菌药物,是减少医院感染发生的关键。

Objective To investigate the characteristics, risk factors and drug resistance of nosocomial fungal infection in infectious disease hospitals. Methods Retrospective investigation of nosocomial fungal infection between 2003 and 2005 was performed. Results The infection rate in 2003 and 2005 was 1.16% and 1.62%, respectively. 19 fungal species were identified. Albicans candida（37.67%） and Albicans tropicals （26.71%） were the major species responsible for the infection. 39.04% were infection of intestinal tract, and 32.88% were infection of the oral cavity. The sensitivity of the fungi to anti-fungal drugs itraconazole, amophotericin, and fluconazole was reducing. The fungi also had a high degree of resistance to enconazole, ketoconazole, and miconazole. Both infection and the disease severity are correlated with the long-term use of broad-spectrum antibiotics, improper medical cares, and elderly. Conclusion Nosocomial fungal infections were increasing every year. Development of antibiotic resistance may contribute to the mortality. Effective management of risk factors and proper use of antibiotics were the keys to decrease nosocomial fungal infection.