呼吸内科患者白色念珠菌痰培养阳性的危险因素及耐药性变迁分析

The risk factor of positive sputum culture for Candida albicans and dynamic variation of drug resistance in patients in department of respiratory medicine

目的分析呼吸内科患者白色念珠菌痰培养阳性的危险因素及对常用抗真菌药物的耐药性,为临床预防、早期诊断及有效治疗提供依据。方法对2007年1月至2009年12月浙江大学医学院附属第一医院呼吸内科白色念珠菌痰培养阳性患者的临床资料进行回顾性调查,统计其年龄分布、可能感染因素、基础疾病、被感染前抗菌药物的使用及近3年对抗真菌药物的耐药性变迁。结果呼吸内科白色念珠菌痰培养阳性的相关因素多,老年、气管插管/切开、机械通气、慢性阻塞性肺疾病及长期多种抗菌药物的使用患者中感染几率明显增高,且3年来,白色念珠菌的耐药性有所升高。结论临床上细心操作、抗菌药谨慎使用是目前减少白色念珠菌感染的重要途径。

Objective To analyze the risk factor of positive sputum culture for Candida albicans and the drug resistance to common antifungal drugs in patients in department of respiratory medicine, so as to provide basis for clinical prevention and early diagnosis and active treatment. Method Clinical samples collected from inpatients in the respiratory medicine department of the First Affihated Hospital of Zhejiang University School of Medicine from Jan 2007 to Dec 2009 were analyzed retrospectively. The ages, factors, underlying diseases, usage of antibacterial drugs and the dynamic variation of drug resistance in the last 3 years were reviewed. Result There were many factors resulting in positive sputum culture for C. albicans in department of respiratory medicine. The probability of positive sputum culture for C. albicans rose obviously in patients with elder ages, tracheotomy tube, mechanical ventilation, chronic obstructive pulmonary diseases and long-term usage of antibacterial drugs. And the drug resistance of C. albicans was rising in recent 3 years. Conclusion An important way of reducing positive sputum culture for Candida alb/can is to carefully operate and properly use antibiotics.