临床患者口腔真菌的携带特征及其药敏检测

Epidemiology of oral yeast colonization and drug resistance of the involved fungi

目的:通过对临床非真菌病患者口腔真菌的分离鉴定及其药敏检测,了解不同患者的真菌携带状况、种群分布及其对常用抗真菌药物的敏感性等,为临床防治真菌病提供参考依据。方法:对92例住院患者常规棉拭子口腔取材、真菌分离培养、科玛嘉显色法鉴定,分析不同疾病、年龄段患者假丝酵母菌的检出情况,并进行氟康唑、两性霉素B、酮康唑、氟胞嘧啶及伊曲康唑纸片法药敏测定。结果:92例样本经真菌培养,分离出53例(57.61%)假丝酵母菌;受检患者多以心脑血管疾病为主,其次为呼吸系统感染;60岁以上患者分离率(65.15%)显著高于60岁以下组(38.46%)(P<0.05);显色法鉴定白假丝酵母菌28例,热带假丝酵母菌8例,其它假丝酵母菌17例;所分离的真菌对5种药物均有不同程度的耐药性,其中对酮康唑的耐药性最高。结论:临床患者口腔黏膜真菌携带具有分离率高、年龄及病种相对集中的特征;菌群以白假丝酵母菌为主;分离株耐药性较普遍。

Objective：To investigate the epidemiology of oral yeast colonization and drug resistance amongst clinical patients.Methods：Oral examination and microbial swabs were obtained from a total of 92 inpatients for yeast culture in order to reveal the prevalence of Candida pelliculosa colonization by isolation and cultivation of fungi,and to detect its susceptibility to fluconazol,amphotericin B,ketoconazole,fluorocytosine,itraconazole.Results：Candida pelliculosa colonization was found in 57.61%（53/92） of these patients,most of whom were suffering from cardiovascular and cerebrovascular diseases followed by respiratory tract infection.The prevalence of Candida pelliculosa colonization was significant higher among those over 60 years old compared with their younger counterparts（P0.05）.It was also revealed there were 28 Candida albicans,8 Candida tropicalis and 17 other Candida colonization,all the cultivated fungi were resistance to the 5 kinds of tested drugs,most obviously to ketoconazole.Conclusions：The prevalence of oral Candida carrier amongst the examined clinical patients is characterized by high isolation rate,high incidence among older patients with cardiovascular and cerebrovascular diseases or respiratory tract infection,and the most prevalent pathogen was mainly Candida albicans.Besides,most of the isolated strains are resistant to conventional anti-fungal agents.