重症监护室肺部真菌感染病原菌的分离鉴定与耐药性分析

Isolated identification and analysis of drug resistance of pathogen infected by pulmonary fungus in intensive care unit

目的了解我院重症监护室(ICU)肺部真菌感染和药敏测试情况,指导临床用药。方法收集我院ICU及神经外科ICU住院患者确诊为肺部感染的呼吸道标本1200份,对其检出280株真菌进行6种常用抗真菌药的体外敏感性检测。结果在检出的280株真菌中菌种分布以白色念珠菌为主,196株,占70.0%,其次为热带假丝念珠菌48株,占17.1%;对6种常用药物进行耐药性分析,除克柔念珠菌对氟康唑耐药外,其他真菌对5-氟胞嘧啶、制霉菌素和两性霉素B比较敏感。结论临床上念珠菌的感染和耐药菌株在不断上升,应加强念珠菌的临床检测和耐药性分析。

Objective To study the infection of pulmonary fungus and results of antifungal susceptibility test in intensive care unit （ICU）of our hospital, and make guidance for clinical medication. Methods 1200 samples from respiratory tract of the patients with pulmonary infection in ICU and the ICU of neurosurgery of our hospital were collected. The vitro susceptibility tests of 6 antifungal drugs for 280 fungus isolates were taken. Results Of 280 strains detected, the strain number of Candida albicans and Candida tropiealis was 196 （70.0%） and 48 （17.1%） , the main type was Candida albicans ; according to the analysis of drug resistance in 6 drugs commonly used, it showed that except Candida krusei was resistant to fluconazole, the other fungi were sensitive to 5-fiueytosine, nystatin and amphotericin B. Conclusion The infection and drug-resistant strains of Candida are rising clinically, and we should strengthen the clinical detection and analysis of drug resistance of Candida.