念珠菌菌血症的易感因素分析及药敏检测

Predisposing factor analysis and susceptibility tests of candidemia

目的探讨念珠菌菌血症的临床特点、菌种构成、危险因素及药敏情况,为临床治疗提供依据。方法收集我院2005年6月1日～2007年5月31日自血培养中分离出的92株念珠菌的菌种分布、药敏试验和危险因素等资料进行回顾性分析。结果菌种分布显示白念株菌感染为28.3%,除白念珠菌、光滑念珠菌、克柔念珠菌、热带念珠菌之外的其他念珠菌感染为45.6%。药敏试验显示耐氟康唑率达41.3%。感染的危险因素有免疫力低下、严重基础疾病、长时间应用广谱抗生素、介入诊治、气管切开及呼吸机的应用等,病死率超过55.4%。结论氟康唑不能作为所有酵母菌感染的首选药物。积极治疗原发病、加强病原学检测和药敏试验、及时作出早期诊断、严格掌握用药原则是降低病死率的关键。

Objective To study the clinical characteristics,stain distribution, predisposing factors and susceptibility tests of candidemia. Methods Ninty-two candida strains isolated from blood from June 1st 2005 to May 31th 2006 in our hospital was studied retrospectively. Results C. ablicans accounted for 28.3% of all strains and other uncommon candida 45.6%. The fluconazol resistance rate in candidemia was high（41.3%）. The predisposing factors included immunodeficiency, serious underlaying diseases, long time administration of broad-spectrum antibiotics, interventional therapy, incision of trachea and mechanical ventilation. Overall mortality rate exceeded 55.4%. Conclusion Fluconazol was not the first choice of all kinds of yeast infections. Important measures to reduce mortality include curing the underlying diseases, emphasis on monoitoring fungal pathogen and susceptibility tests, early diagnosis and compliance medication principles.