院内侵袭性深部真菌感染80例临床与病原学分析

Hospital-acquired Invasive Fungal Infections:Clinical and Etiological Analysis of 80 Cases

目的探讨深部真菌感染的现状、病原菌的种类、常用抗真菌药物的敏感性及防治策略。方法回顾性地分析2004年1月-2005年12月,真菌感染患者的临床状况,并对收集的病原菌进行体外药敏测定。结果2年中共收集88株真菌培养阳性的临床标本,其中确诊或疑诊为假丝酵母菌属感染者72例,占81.8%,其次为新型隐球酵母菌8例,占9.1%,曲霉菌属5例,占5.7%,其余为其他真菌;其中假丝酵母菌属中最常见的病原菌为白色假丝酵母菌,共48株,占66.7%,其次为光滑假丝酵母菌12株,占16.7%,再次为热带假丝酵母菌8株,占11.1%,最后为近平滑假丝酵母菌和克柔假丝酵母菌各2株,分别占2.8%。结论假丝酵母菌属仍然是院内深部真菌感染的主要致病菌,而假丝酵母菌属中最常见的是白色假丝酵母菌感染,氟康唑仍是治疗假丝酵母菌属尤其是白色假丝酵母菌感染最有效的药物。

OBJECTIVE To study the prevalence, fungal species, therapy and prevention of invasive fungal infections in our Affiliated Hospital. METHODS From Jan 2004 to Dec 2005, all patients with positive results for fungal culture of blood and sterile fluid were reviewed retrospectively. The in vitro activity of antifungal agents against fungal isolates was determined. RESULTS Eighty-eight positive patients were collected in this analysis based on the diagnosis of invasive fungal infection in our hospital for two years, from them the majority were diagnosed as candidal infections （n= 72, 81. 8%）, the others were Cryptococcus neo f ormans （ n = 8, 9. 1% ） , Aspergillus （n=5, 5. 7%） and other different fungal infections. The most common was C. albicans（n= 48, 66. 7%）, C. glabrata（n=12, 16. 7%）, and C. tropicalis（n=8, 11. 1%）,C. parapsilosis and C. krusei were both the same results（n=2, 2.8%）. CONCLUSIONS Infections caused by Candida are the most common invasive fungal ones in our hospital, and C. albicans is the most common one. Fluconazole remains effective for treament of candidal infections, especially those caused by C. albicans.