453例院内真菌感染致病菌分布及药物治疗分析

Nosocomial fungus infections:a clinical medicine application analysis of 453 cases

目的了解梅州市人民医院真菌感染原的分布及其药物敏感性,通过促进合理用药来预防和治疗院内真菌感染。方法依据真菌感染体外试验报告、并追踪归档病历对用药情况进行回顾性调查,对2005年6月至2008年6月间本院真菌感染病例共计453例进行统计分析。结果453例真菌体外药敏试验报告表明白色念珠菌是最常见的致病菌,占70.19%,其次为热带念珠菌、光滑念珠菌、近平滑念珠菌。真菌感染治疗方面存在不注意采取措施预防真菌感染,不重视治疗基础疾病和增强机体免疫功能,不合理选择和更换抗真菌药物,过渡担心药物毒性DrugToxicity等问题。结论近几年院内真菌感染主要由白色念珠菌引起;感染的预防及治疗应综合考虑患者的个体状况合理用药。

Objective Get the distribution message of the pathogens responsible for the fungal infections in this hospital and its drug sensitivity; prevent and cure the infections by promoting rational drug therapy. Methods 453 cases of hospital fungal infection from June 2005 to June 2008 were analyzed statistically by investigating the reports of in vitro drug sensitivity test combined the case history analysis of drug therapy. Results The 453 reports of dug sensitivity test against fungi showed that baisenianzhujun was the majority of all the identified pathogens and the ratio was 70. 19% , subsequently was Candida ropicalis, Candida glabrata, and Candida parapsilosis in order. Case history analysis of drug therapy revealed that there are some problems with the fungal infection treatment, including not taking enough measures to prevent the infection, not giving enough consideration on underlying disease treatment and body immunity enhancement; not rationally choosing or changing the anti-fungal agents; worrying the drug toxicity overly, etc. Conclusions Hospital fungal infection is caused mainly by baisenianzhujun in recent years, whose prevention and treatment should be done by rational drug therapy based on the personal status of the patients.