浙江省人民医院2009～2011年真菌耐药性分析

Analysis of Drug Resistance of Fungi in Zhejiang Provincial People's Hospital from 2009 to 2011

目的了解临床真菌分离株耐药性,为临床合理用药提供依据。方法用ATB-F3法对浙江省人民医院2009年1月～2011年12月临床真菌分离株进行药敏实验。结果在4 398株临床分离真菌中,排名前3位的为白念珠菌(75.81%)、热带念珠菌(19.42%)、光滑念珠菌(1.55%);非白念珠菌的分离率有增加趋势。5种抗真菌药物对白念珠菌均有很高的敏感性(耐药率≤1.8%),但氟康唑和伊曲康唑对白念珠菌的耐药性有逐年增加趋势。对于热带念珠菌、光滑念珠菌,3种唑类抗真菌药物已有较高的耐药率(7.4%～65.2%),两性霉素B及氟胞嘧啶耐药率较低(0%～7%)。结论对非白念珠菌感染应慎用唑类抗真菌药;两性霉素B和氟胞嘧啶对3种主要念珠菌均具有较高的敏感性。

Objective To investigate the drug resistance of fungi isolated from our hospital, so as to provide evidence for reasonable use of antibiotics. Methods The sensitive tests of fungi of clinical isolated strain were taken by ATB-F3 method. Results Among 4 398 fungi, the top three were Candida albicans （75.81%）, Candida tropicalis （ 19.42% ） , Torulopsis glabrata （1.55%） ;the non-Candida albicans isolated was in upward trend every year. All the five antibiotics had high susceptibility to Candida albicans. However, the resistance to fluconzole and itraconazole of Candida albicans increased year by year. For Candida tropicalis and Torulopsis glabrata, the three pyrroles antibiotics showed high drug resistance（ 7.4%-65.2% ）. Nevertheless, the resistance to Amphotericin B and 5-fluorocytosine was low（0%-7% ）. Conclusion The pyrroles antibiotics should be used with caution for the non-Candida albieans infection. Amphoteriein B and 5-fluoroeytosine show high sensitivity to the three main Candida.