临床分离508株酵母菌的菌种分布及耐药性分析

Distribution and antifungi resistance of 508 strains of Candida isolated from clinic

目的了解某院临床分离酵母菌的种群分布与耐药情况,为合理用药提供依据。方法以常规方法培养真菌,并采用法国生物梅里埃公司VITEK-32微生物分析仪YBC酵母菌卡进行鉴定;药敏试验以微量稀释法进行。结果共检出508株酵母菌,其中以白假丝酵母菌最多,达369株(72.64%),其次为热带假丝酵母菌48株(9.45%),无名假丝酵母菌26株(5.12%)。93.22%(344/369)的白假丝酵母菌和89.58%(43/48)的热带假丝酵母菌由呼吸道分泌物标本分离,呼吸道分泌物酵母菌的分离率显著高于其他临床标本(χ2=644.26,P<0.01)。白假丝酵母菌对5-氟胞嘧啶、两性霉素B、氟康唑、伊曲康唑和伏立康唑的MIC90分别为≤16mg/L、≤0.5mg/L、≤1mg/L、≤0.25mg/L和≤0.06mg/L,耐药率为1.12%(3/269)～10.78%(29/269)。结论该院临床酵母菌的检出以白假丝酵母菌为主,主要分离自呼吸道标本。白假丝酵母菌对氟康唑等临床常用抗真菌药物的耐药性相对较低,但仍应加强对临床酵母菌的药敏监测。

Objective To investigate the distribution and drug resistance of clinical isolated Candida , so as to provide basis for clinical treatment. Methods Fungi culture was performed with routine method, strains of Candida were identified with VITEK 32 Automicrobic System, drug sensitive test of Candida was tested by microdilution method. Results Among 508 strains, Candida albicans accounted for 369 strains（72. 64%）, Candida tropicalis 48 strains（9. 45%）, Candida famata 26 strains（5. 12%）. 93. 22%（344/369） of Candida albicans and 89. 58%（43/ 48） were isolated from respiratory tract samples, the isolation rate of Candida from respiratory tract was obviously higher than that from the other clinical samples （x^2 = 644. 26, P〈0. 01） . The MIC50 of Candida albicans to fluorocytosine, amphoteriein B, fluconazole, itraconazole and voriconazole was ≤16 mg/L, ≤0. 5 mg/L,≤1 mg/L,≤ 0. 25 mg/L and ≤0. 06 mg/L respectively, antifungi-resistant rate were 1. 12% （3/269） - 10. 78% （29/269）. Conclusion The main isolated Candida in this hospital is Candida albicans, most of which were isolated from respiratory samples. The resistance of Candida albicans to antifungi drug are relatively low, the monitor of drug resistance of Candida is still necessary.