2002-2006年浙医一院重症监护室真菌流行病学调查

Study on the epidemiology of fungi in intensive care unit of the First Affiliated Hospital of ZhejiangUniversity

目的调查2002-2006年浙医一院重症监护室（ICU）的真菌分布及流行趋势。方法收集2002-2006年浙医一院ICU送检的所有真菌检查阳性结果及药敏情况，并进行数据统计和分析。结果送检的标本量从2002年的2692例上升至2006年的6082例。每年检测到的真菌株数从415例上升到607例，真菌培养阳性率为8．5％-15．4％。主要为白念珠菌（55．2％-63．1％），其次为光滑念珠菌（8．2％-17．8％）、热带念珠菌（6．0％-15．3％）、曲霉菌（2．4％-7．3％）。不同标本来源分离的菌株分布情况：痰液中分离的真菌以白念珠菌为最多，其次为光滑念珠菌、热带念珠菌、曲霉菌等；血液中分离的真菌亦以白念珠菌为最多，其次为光滑念珠菌、热带念珠菌、近平滑念珠菌；尿液中分离的真菌以热带念珠菌为最多，其次为白念珠菌、光滑念珠菌；大便、引流液分离的真菌均以白念珠菌为最多。2004-2006三年的药敏情况可见，5-氟胞嘧啶及二性霉素B敏感性一直很好，未出现耐药菌株，白念珠菌及热带念珠菌的药物敏感性变化不大，而光滑念珠菌对氟康唑及伊曲康唑的敏感性有下降趋势。结论2002-2006年浙医一院ICU临床分离的真菌仍以白念珠菌所占比例最大，其次为光滑念珠菌和热带念珠菌，热带念珠菌和曲霉菌所占比例有所增高。不同标本分离的菌株所占比例有所不同。光滑念珠菌对氟康唑及伊曲康唑的敏感性呈逐年下降趋势。

Objective To study on the epidemiology of nosocomial infected fungi collected in intensive care unit（ICU） of the First Affiliated Hospital of Zhejiang University from 2002 to 2006. Methods The data of fungi which were isolated in intensive care unit of the First Affiliated Hospital of Zhejiang University from 2002 to 2006 were collected and analyzed. Result The total clinical samples were 2692 in 2002 and increased to 6082 in 2006 ,and the positive samples increased from 415 to 607. The percentage of positive samples were 8. 5% - 15.4%. Candida albicans was the most commom species （55.2% 63. 1% ）, followed by Candida glabrata（8.2% - 17.8% ） ,Candida tropicalis （6.0% - 15.3% ） ,Aspergillus （2.4%-7.3% }. No resistant organism was found to 5 -fluorocytosine and amphotericin B from 2004 to 2006. The susceptibilities of Candida albicans and Candida tropicalis to antifungal agents little changed, but Candida glabrata showed decreased susceptibility to Fluconazole and Itraconazole. Conclusions Candida albicans was the most frequent species in ICU of the First Affiliated Hospital of Zhejiang University from 2002 to 2006, followed by Candida giabrata and Candida tropicalis. The percentage of Candida tropiealis and Aspergillus were increased. Candida glabrata showed decreased susceptibility to Fluconazole and Itraconazole.