62例真菌菌血症回顾性研究

Fungemia:A Retrospective Analysis of 62 Cases

目的研究真菌菌血症临床特点、可能的相关因素、病原谱及药敏特点,为真菌菌血症防治提供依据。方法回顾性地研究医院2003-2004年发生的62例真菌菌血症。结果95.2%的真菌菌血症为医院感染;59例长期应用广谱抗菌药物(95.1%)、中心静脉置管(46.8%)、气管切开及机械通气(38.7%);分离出的病原菌依次为白色假丝酵母菌(16株)、近平滑假丝酵母菌(12株)、光滑假丝酵母菌(11株)、热带假丝酵母菌(10株);对氟康唑敏感性均>90%(热带假丝酵母菌除外)。结论非白色假丝酵母菌感染导致的真菌菌血症逐渐增多,广谱抗菌药物的应用及中心静脉置管与真菌菌血症相关性可能更强,氟康唑对除热带假丝酵母菌、克柔假丝酵母菌外的多种真菌有良好的抗菌活性。

OBJECTIVE To investigate the clinical characteristics, predisposing factors, pathogenicity and antifungal susceptibility of fungemia and to provide evidence for prevention and therapy. METHODS A total of 62 cases with fungemia were retrospectively analyzed which abtained from 2003 to 2004 in our hospital. RESULTS 95.2% of these cases were hospital-acquired infection. Fifty nine cases were associated with previous administration of broad-spectrum antibiotics （95.1%）, central venous catherization （46.8M） and tracheotomy or mechanical ventilation （38.7%）. Candida albicans comprised 16 cases of fungemia, followed by C. parapsilosis （12）, C. glabrata （11）, and C. tropicalis （10）. The sensitivity rate to fluconazole of these first three species were all above 90% except C. tropicalis. CONCLUSIONS Our findings highlighted the incresing of fungemia caused by non-C, albicans yeast. Prior broad spectrum antibiotics use and central venous catheterization are significantly associated with fungemia. Fluconazole still keeps good antifungal activity to the species except C. krusei and C. tropicalis.