肿瘤患者临床分离真菌的分布及耐药性分析

Distribution and drug resistance of fungi isolated from tumor patients

目的观察象山县红十字台胞医院和象山县第一人民医院肿瘤患者临床分离真菌的菌株分布及其耐药性分析。方法对2008年1月-2011年1月临床送检标本检出的216株真菌,进行培养鉴定菌种和耐药性分析。结果 216株真菌以白色假丝酵母菌为主,其次依次为热带假丝酵母菌、光滑假丝酵母菌、克柔假丝酵母菌、近平滑假丝酵母菌,分别占58.3%、18.1%、9.7%、5.6%、5.1%;象山地区2所医院真菌感染,以呼吸道感染为主,其次依次为泌尿道、消化道、皮肤黏膜、血液,分别占50.9%、16.7%、14.8%、7.4%、6.0%;216株真菌对伊曲康唑的耐药率最高,高达45.4%,氟康唑位于第2位,其次依次为克霉唑、两性霉素B和制霉菌素,耐药率分别为40.7%、22.7%、10.2%和5.6%,对5-氟胞嘧啶最为敏感,敏感率为90.3%。结论 2所医院的肿瘤患者真菌感染较为严重,临床应根据药敏试验结果合理应用抗菌药物。

OBJECTIVE To observe the strain distribution and drug resistance of fungi isolated from tumor patients.METHODS From Jan 2008 to Jan 2011,a total of 216 strains of fungi were cultured and tested drug-resistance.RESULTS Of 216 strains of fungal,Candida albicans was the main fungal strains,58.3%,and then the next was Candida tropicalis,accounting for 18.1%,Candida smooth,accounting for 9.7%,Candida krusei,accounting for 5.6% and Candida parapsilosis,accounting for 5.1%.Respiratory tract was the main fungal infection site,50.9%,and then the next was urinary tract,accounting for 16.7%,digestive tract,accounting for 14.8%,skin and mucous membranes,accounting for 7.4% and blood 7.7%.The highest rates of resistance to flucytosine,up 44.4%,fluconazole in the second,resistance rate was 40.7%,followed by clotrimazole,amphotericin and nystatin,resistance rates were 22.7%,10.2% and 5.6%,on the most sensitive to flucytosine,sensitive rate was 90.3%.CONCLUSION Fungal infection in cancer patients in hospital is serious,and clinical treatment with antimicrobial should be rational used based on susceptibility test results.