血液真菌感染的菌群分布及耐药性分析

Blood fungal infection:species distribution and drug resistance

目的分析本院近3年来血液真菌的分离率、菌种分布和耐药特性。方法收集自2004年8月～2007年7月3年间住院患者的血液标本,经BacT/ALERT3D血培养仪培养,沙保罗培养基分离培养真菌,柯玛嘉显色培养基和VITEK-60YBC卡进行菌种鉴定,Rosco纸片扩散法测定药敏。结果8707份血液标本中共分离出93株真菌,分离率为1.07%,其中白念珠菌41株,占44.09%,热带念珠菌16株,占17.20%,光滑念珠菌13株,占13.98%,对氟康唑的耐药率分别为:2.4%、6.3%和23.1%,对两性霉素B和制霉菌素均敏感。结论我院血液真菌感染的病原菌以白念珠菌为主,热带念珠菌和光滑念珠菌次之,白念珠菌和热带念珠菌对唑类药物敏感性较高,光滑念珠菌对唑类药物的耐药率较高,两性霉素B和制霉菌素的抗菌活性最强。

Objective To investigate the isolating rate, species distribution and drug resistance of fungal isolates from blood culture in our hospital during the past three years. Methods Blood samples were collected in our hospital between August 2004 and July 2007, cultured with BacT/ALERT 3D, separated with Sobaurand＇s agar culture medium, identified with CHROMager medium and VITEK-60 YBC, tested the drug sensitivity with Rosco disk diffusion method. Results Of the specimens in 8707 cases, there were 93 fungal isolates, and the isolating rate was 1.07%. Among the 97 isolates, 41 （44.09%） were Candida. albicans, 16（ 17.20% ） were C. tropicalis, 13（ 13.98% ） were C. glabrata. And their drug resistance rates to fluconazole were 2.4%, 6.3% and 23.1%, respectively. All isolates were sensitive to amphotericin B and nystatin. Conclusions The majority of tested strains from blood were C. albicans, followed by C. tropicalis and C. glabrata, C. albicans and C. tropicalis were sensitive to azoles class antifungal agent. C. glabrata was resistant to azoles. Antifungi activity of amphotericin B and nystatin were higher than others.