念珠菌对临床常用抗真菌药物的耐药性分析

Survey on drug resistance of Candida to common antifungal drugs

目的研究本地区念珠菌感染构成及对临床常用抗真菌药物的耐药情况。方法使用念珠菌显色培养基对念珠菌进行培养鉴定,并用现行纸片扩散法(K-B法)进行药敏实验。结果 267例念珠菌感染中呼吸道标本占70.8%、尿液占16.9%,脓液6.4%,胸腹水3.4%,脑脊液0.7%,血液1.9%;菌种分布分别为白色念珠菌占61.4%,热带念珠菌占10.9%,克柔念珠菌占6.4%,光滑念珠菌占8.6%,其他念珠菌占12.7%;耐药情况分别为两性霉素B耐药性1.1%,5-氟胞嘧啶13.1%,依曲康唑46.4%,氟康唑48.3%,酮康唑34.8%。结论念珠菌的感染呈上升态势,菌种分布及耐药性表现均不同,临床上应根据药敏实验合理使用抗真菌药物。

Objective To study the drug resistance of Candida to commonly used antifungal drugs and to survey the distribution of Candida infection in this area.Methods By using Candida color culture medium for cultivation and identification of Candida,and K-B method was used for drug sensitivity testing.Results The specimens from respiratory tract of 267 cases of Candida infection accounted for 70.8%,urine specimens accounted for 16.9%,pus specimens for 6.4%,pleural effusion and ascites for 3.4%,cerebrospinal fluid for 0.7% and blood samples for 1.9%.Among species distribution,Candida albicans accounted for 61.4%,Candida tropicalis accounted for 10.9%,Candida krusei accounted for 6.4%,Candida glabrata accounted for 8.6%,and other species of Candida accounted for 12.7%.The rate of resistance was 1.1% to amphotericin B,13.1% to 5-fluorocytosine,46.4% to itraconazole,48.3% to fluconazole and 34.8% to ketoconazole.Conclusion The incidence of infection with Candida is in rising tendency,distribution of species and manifestations in drug resistance are different,hence clinical medication should be based on drug sensitivity test for rational application of antifungal drugs.