医院感染酵母样真菌的临床分布与耐药性分析

Candida Causing Nosocomial Infection:Clinical Distribution and Drug Resistance

目的探讨医院真菌感染现状、流行病学特征及对抗真菌药物的敏感性,为临床真菌感染的预防和治疗提供理论依据。方法对2008年1月-2010年6月,发生酵母样真菌医院感染住院患者的年龄、标本、菌种分布、科室、药敏试验进行分析。结果收集医院感染酵母样真菌感染标本470例,其中白色假丝酵母菌259株(55.1%)、热带假丝酵母菌72株(15.3%)、光滑假丝酵母菌51株(10.9%);真菌医院感染部位最常见的是下呼吸道(70.0%);患者年龄>60岁占69.1%;以痰液标本为主,占70.0%,其次为粪便和尿液,分别占9.8%和4.5%;酵母样真菌医院感染高发科室有综合ICU和老年科;酵母样真菌对伊曲康唑、两性霉素B、5-氟胞嘧啶和氟康唑敏感率分别为97.4%、99.7%、97.7%和96.9%。结论医院内酵母样菌属感染较高,多发生于>60岁老年患者,感染部位以下呼吸道多见,伊曲康唑、两性霉素、5-氟胞嘧啶和氟康唑对假丝酵母菌属有较好的抗菌活性。

OBJECTIVE To explore the Candida infection, its clinical distribution and susceptibility to antifungal agents, and provide a theoretical proof for controlling fungal infection. METHODS The specimens of nosocomial fungal infection in hospital from Jan 2008 to Jun 2010 were collected, and the isolates were identified, then the epidemiologic analysis for cases according to the age of patients, source of samples, species and division distribution was performed. RESULTS Totally 470 strains of Candida were collected. The infection rate of Candida albicans was as high as 51.1%, followed by C. tropicalis （15.3%） and C. glabrata （10.9%）. The main site of nosocomial fungal infection was the lower respiratory tract. 69. 1% of patients were older than 60 years old. Sputum was predominant sample, accounted for 70. 0%. The medical departments with the most common infection were ICU and geriatrics department. The sensitivity rate of years to itraconazole, amphotericin B, flucytosine and fluconazole were 96. 89%, 99. 72%, 96. 39% and 95. 84%, respectively. CONCLUSION The nosocomial fungal infection is common, most occurs in old people more than 60 years. The most common infection site is lower respiratory tract. Itraconazole, amphotericin B, flucytosine and fluconazole have good susceptibility for yeast-like fungi.