慢性阻塞性肺疾病继发真菌感染病原菌分布及耐药性分析

目的分析慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者继发真菌感染的病原菌分布及其耐药性情况。方法对郴州市杨家坪郴州博雅医院2009～2011年收治的320例COPD患者采集痰液标本,使用CANDIFAST真菌二合一检测试剂进行真菌的培养和分离鉴定,并进行耐药性检验。结果 320例患者中发生真菌感染36例,发生率11.25%,其中白色念珠菌22例(61.11%),光滑念珠菌5例(13.89%),热带念珠菌3例(8.33%),酵母样真菌3例(8.33%),克柔念珠菌2例(5.56%),曲霉菌1例(2.78%)。药敏试验可见,各药耐药性两性霉素B2.77%,伊曲康唑13.89%,氟胞嘧啶25.0%,氟康唑38.89%,酮康唑38.89%。结论 COPD继发真菌感染发生率较高,以白色念珠菌为主,以两性霉素B、伊曲康唑等抗真菌效果较好。

Objective To analyze the fungus distribution and drug resistance of secondary fungus infection after COPD. Methods Sputamentum samples of 320 COPD patients during 2009-2011 were collected and the CANDIFAST fungi test reagent was used to cultivate and identify the pathogenic fungi. Results 36（22.5%） patients of 320 were found fungus infected. 22（61.11%） of the infected patients were by Candida albicans,5（13.89%） were by Candida glabrata,3（8.33%） were by Candida tropicalis,3（8.33%） were by Yeast,2 （5.56%） were by Candida krusei and 1（2.78%） were by Aspergillus. The drug senseitive test showed that the drug resistance rate ofAmphotericin B was 2.77%,Itraconazole 13.89%,Flucytosine 25.0%,Fluconazole 38.89% and Ketoconazole 38.89%. Conclusion The secondary fungal infection rate after COPD is mainly caused by Candida albicans and the amphotericin B and Itraconazole were effective for treatment.