假丝酵母菌感染的临床分布及耐药性分析

Analysis on clinical distribution and drug resistance of candida infection

目的探讨引起医院感染常见的假丝酵母菌的临床分布及其耐药性特点,为临床抗真菌药物的合理使用提供依据。方法收集我院2008年1月至2010年12月的各种临床标本,进行培养分离纯化,法国梅里埃生物进行真菌的鉴定及药敏试验。结果 3年共分离出假丝酵母菌537株,占前三位分别为白色假丝酵母菌(69.1%)、热带假丝酵母(14.1%)、光滑假丝酵母(7.3%);在临床标本中,痰液分布率最高,占78.8%;感染分布以呼吸内科为主,占31.1%;假丝酵母菌对两性霉素、5-氟胞嘧啶敏感率较高,而对唑类(氟康唑、益曲康唑)药物的耐药率较高。结论真菌感染以白色假丝酵母菌为主,对5种抗真菌药物出现不同程度的耐药,合理使用抗真菌药物,提高临床治疗效果。

Objective To discuss clinical distribution and the drug resistance of candida infection in hospital,and to provide evidence for the clinical use of anti-fungal drugs.Methods Clinical specimen from January 2008 to December 2010 was collected for culture,isolation and purification,and then Fungal identification and drug sensitivity were tested by bioMerieux French.Result 537 candida strains were isolated mainly including candida albicans（69.0%）,candida tropicalis（14.1%） and candida glabrata（7.3%）.Rate of distribution in sputum was the highest and was 78.6%.Infection mainly occurred in respiratory medicine,accounting for 36.2%.The candida were rather sensitive to amphotericin B,5-fluorocytosine,but resistant to pyrroles（fluconazole,itraconazole）.Conclusion Candida albicans was the main fungal infections,and it was resistant to 5 kinds of anti-fungal drugs in different extent.Rational use of anti-fungal drugs can enhance the clinical therapeutic efficacy.