肿瘤患者深部真菌医院感染的菌群分布及耐药性调查

Flora Distribution and Drug-resistance in Tumor Patients with Deep Fungal Nosocomial Infection

目的探讨肿瘤患者深部真菌医院感染的病原菌分布特点及耐药现状，为临床医师预防与控制真菌医院感染提供科学依据。方法对153例深部真菌医院感染的肿瘤患者临床资料进行回顾性调查，真菌培养、鉴定和药敏试验严格按照《全国临床检验操作规程》进行。结果肿瘤患者深部真菌医院感染以下呼吸道为主，占61．4％；其次为消化道，占13．1％；真菌主要是白色假丝酵母菌（60．1％）和热带假丝酵母菌（20．9％）；真菌药敏试验结果表明，深部真菌对两性霉素B和制霉菌素耐药率均为0；对伊曲康唑及克霉唑的耐药率为0～7．6％，对氟康唑耐药率有上升趋势，为17．4％～30．0％。结论应重视肿瘤患者真菌医院感染的病原学检查和药敏监测，才能有效地控制真菌医院感染。

OBJECTIVE To approach the flora distribution and drug-resistance status in deep fungal nosocomial infection in tumor patients and offer scientific evidence of prevention and controlling of it. METHODS Retrospective reviews were performed to analyze the 153 cases of deep fungal nosocomial infections in tumor department. Fungal cultivation, identification and susceptibility tests were performed strictly according to Rules of Operation in Clincal Laboratory of Nationwide. RESULTS The lower respiratory tract was the main site in deep fungal nosocomial infection in tumor patients, accounting for 61.4%. The digestive tract infection rated the second, accounting for 13.1%. Pathogenic bacteria mainly included Candida albicans （60.1%）and C. tropicalis （20.9%）. The susceptibility test showed that the drug-resistance rate to amphotericin B and nystatin were all 0 and that to itraconazole and clotrimazole was 0- 7. 6%. The resistance rate （17. 4- 30. 0%） to fluconazole showed upgrading tendency. CONCLUSIONS We should think highly of etiological detection and monitoring of drug-resistance in deep fungal nosocomiai infections in tumor patients in order to control the infections effectively.