老年患者真菌感染的临床特点和耐药性分析

Clinical ditribution and drug resistance of infection in senile patients

目的:了解老年患者真菌感染的临床特点,并分析其耐药性。方法:回顾性调查2007年1月-2009年12月住院的老年患者发生真菌感染的相关临床资料及药敏试验结果。结果:377例患者标本共分离真菌441株,菌种以假丝酵母菌为主,占94.8%,曲霉菌和毛霉菌占5.2%。呼吸内科和重症监护室的检出率最高,分别为29.3%和25.4%。痰液和尿液是检出菌株数最多的标本,构成比分别占47.2%和23.1%。体外药敏试验结果表明,两性霉素B和5-氟胞嘧啶的敏感性最高。三唑类抗真菌药物中,以伏立康唑耐药率较低,氟康唑对非白假丝酵母菌耐药性较强。结论:假丝酵母菌是老年患者发生医院感染最常见的真菌,且耐药性有增强的趋势。老年患者是真菌感染高危人群,应密切监视患者的体症变化,严格各项医疗操作的无菌要求,降低真菌感染的发生率。

Objective：To investigate the clinical character and drug resistance of infection in senile patients.Methods：The related clinical datas and results of drug sensitivity tests of candida infection in hospitalized senile patients isolated from January 2007 to December 2009 were analyzed retrospectively.Results：Four hundred and forty one strains of fungi were isolated from 377 patients specimen and most of them were Candida Spp.（94.8%）,the rest were aspergillus and mucorpusillus（5.2%）.The departents of respiratory and ICU had the top relevance ratio which were（29.3%）和（25.4%.）Most fungi were found in sputum（47.2%） and urine（23.1%） got from patients.There had a highest susceptibility rate to amphoterien B and 5-fluoruytosine according to drug sensitivity tests in vitro.Within eriazole antifurgals,the resistante rate of candida to voriconazole was low,and nevertheless,the resistante rate of non-candida albicans was high.Conclusion：Candida has been one of the most common pathogens proceed from senile patient nosocomial infection,and that drug resistance is increasing.Senile patients are high risk group and attention are necessary to whose physical symptom change.Strict standards of asepsis operation will help to reduce the incidence rate of fungi infection.