呼吸道真菌感染病原菌分布及耐药性分析

Distribution and Resistance Analysis of Respiratory Tract Fungal Infection

目的:了解临床住院患者呼吸道真菌感染的病原菌分布情况,分析常见真菌种类及耐药特点,及时为临床提供合理用药的依据。方法:用科玛嘉念珠菌显色平板进行鉴定分型,用ATB FUNGUS3真菌药敏板条进行药敏试验,用Whonet5.0软件对数据进行分析。结果:对2007年11月-2008年10月期间的住院患者送检的2 563例呼吸道标本进行真菌培养,共有230例培养出念珠菌,阳性检出率为9.0%。其中白色念珠菌142例(61.7%),热带念珠菌36例(15.7%),克柔念珠菌26例(11.3%),光滑念珠菌26例(11.3%)。念珠菌各型对5种抗真菌药物敏感率由高到低依次为:两性霉素B(100%),5-氟胞嘧啶(98.2%),伏立康唑(95.7%),氟康唑(88.7%),伊曲康唑(87.0%)。结论:目前引起我院患者真菌感染的念珠菌仍以白色念珠菌为主,其次是热带念珠菌。这些念珠菌对两性霉素B、5-氟胞嘧啶、伏立康唑较敏感;对氟康唑、伊曲康唑产生了较强的耐药性。

Objective： To investigate the characteristics of respiratory tract fungal infection and analyze drug resistance pattern. Methods：The fungal isolates were identified by CHROMager medium. The susceptibility were tested by ATB FUNGUS3. The data were analyzed by Whonet 0. Results：There were 2 563 species requested fungus culture from respiratory tract from Nov. 2007 to Oct. 2008. 230 fungi were cultured, the positive culture rate was 9. 0%. There were 142（61.7%） C. albicans, 36（15. 7%） C. tropicalis, 26（11.3%） C. krusei and 26（11. 3%） C. glabrata. The susceptibility to amphotericinB, 5-fluorocytosine, voniconazole, fluconazole, itraconazole were 100 %, 98. 20%, 95.7%, 88. 7%, 87. 0%, respectively. Conclusion. C. albicans accounted for the most of respiratory tract fungal infection. AmphotericinB,5-fluorocytosine and voniconazole were effective for treatment of candida infections, but the resistant percentage to fluconazole and itraconazole were rising.