院内真菌感染及其药物的敏感性分析

The Study of Nosocomial Fungal Infection and Sensitivity to Anti-fungal Agents

目的 :了解院内真菌感染及其药物敏感状态与疗效。方法 :对院内真菌感染危险因素、诊断及抗真菌药物敏感性进行研究。结果 :院内真菌感染 13 9例 ,占同期院内感染的 2 8 4 3 % ;感染主要部位为肺、消化道及泌尿道 ;培养出真菌 14 8株 ,白色念珠菌及热带念珠菌分别为 5 9 4 6%及 2 0 95 % ;抗真菌药物敏感性分别为AMB 5 3 90 %、 5 -FC 5 1 0 6%、KCZ 5 2 4 8%、NYS 2 8 3 7%及FCZ 61 70 % ;氟康唑治疗有效率 81 2 5 %。结论 :肺部念珠菌病最常见 ,严重基础病及长期用抗生素者发病率较高 ,治疗原发病、合理用抗生素、减少侵入性操作等有利于预防院内真菌感染 ,氟康唑治疗有效。

Objective:To investigate the risk factors for nosocomial fungal infection and sensitivity of antifungal agents.Methods:We made clinical study and tested the drug sensitivity to 5 kinds of antimycoin in 139(148 strains) of 6747 cases of discharged patients from 1988 to 1997 according to the standards confirmed by the nosocomial infections monitoring and coordinating group of Ministry of Health.Results:The nosocomial infection were occured in 489 cases,and among them 139(28 43%)cases occured fungal infection.The mainly location of fungal infection were as fallows:lower respiratory tract 104(74 82%),digestive tract 18(12 95%)cases,and urinary tract 9(6 47%)cases.Candida albicans and C.tropcalis were the major pathogens(59 46% and 20 95% respectivly).In vitor antifungi agents sensitive test demonstrated that 53 90% of fungal strians were sensitive to Amphotericin B,51 06% to 5-FC,52 48% to Ketoconazole,28 37% to Nystatin,61 70% to Fluconazol.The effective rate were 81 25% to Fluconazol.Conclusion:We must attention to the nosocomial fungal infection.The measure necessary to prevent nosocomial fungal infection were as follows:treatment of original diseas,rational treatment with antibiotics,reduce intervenient operation,intensive fungal monitoring,and os on.It was effecacy to treat fungal infection with fluconazol.