肿瘤患者临床分离真菌的分布及耐药性分析

Distribution and drug resistance analysis of fungi isolated from clinical cancer patients

目的监测分析临床分离真菌的分布以及抗真菌药物的耐药现状,加强抗真菌药物的合理应用。方法对2009年1～12月分离鉴定出的210株真菌用目前常用的5种抗真菌药物进行药敏试验和分析。结果 210株真菌中念珠菌和其他真菌分别占96.7%和3.3%,其中居前4位的念珠菌依次是白念珠菌(70.5%)、光滑念珠菌(12.9%)、热带念珠菌(8.2%)和克柔念珠菌(3.8%)。呼吸道标本检出率最高,肺癌患者检出率最高。两性霉素B耐药率最低,氟康唑和伊曲康唑对光滑念珠菌和克柔念珠菌耐药率高。结论肿瘤患者临床分离的耐氟康唑光滑念珠菌和克柔念珠菌有升高趋势,微生物室应将念珠菌鉴定到种并对其进行个体化药敏试验,加强耐药性监测。

Objective To monitor the distribution and drug resistance of fungi isolated from clinical cancer patients in our hospital,so as to enhance the rational use of antifungal agents. Methods 210 strains of fungi identified from clinical cancer patients in our hospital from January 2009 to December 2009 were performed the drug susceptibility testing to the current commonly used 5 kinds of antifungal agents and analysed. Results The ratio of Candida and other fungi were 96.% and 3.3% respectively in 210 strains of fungi,in which the top four in turn were Candida albieans （70.5 %）, Candida glabrata（ 12.9% ）, Candida tropicalis （8.2% ） and C. krusei（3.8 % ）. The highest detection rate was in the specimens of respiratory tract and lung cancer patients. The resistance Of fungi to amphotericin B Was the lowest,and that of Candida glabrata and C. kruse to fluconazole and itraconazole were higher. Conclusion There was increasing trend of the fluconazole resistant to the Candida glabrata and C. krusei isolated from clinical cancer patients. Doctor in microbial room should identify the species of Candida and do the individualized susceptibility test and strengthen to the monitoring of drug resistance.