呼吸科慢性阻塞性肺疾病患者酵母样真菌分离及耐药性分析

The distribution and drug resistance of yeast-like fungi isolated from patients with chronic obstructive pulmonary disease in respiratory department

目的调查慢性阻塞性肺疾病合并肺部真菌感染的病原菌分布及耐药性。方法回顾性分析82例浙江大学附属第一医院收治的慢性阻塞性肺疾病患者分离标本,对其进行培养鉴定并分析药敏情况。结果 82例慢性阻塞性肺疾病合并真菌感染的患者检出白色念珠菌45例,热带念珠菌15例,光滑念珠菌11例,近平滑念珠菌8例,克柔念珠菌3例。所有酵母样真菌对5-氟胞嘧啶、两性霉素B敏感率较高,对唑类药物敏感性稍低。结论慢阻肺患者酵母样真菌感染主要以白色念珠菌为主,且所有酵母样真菌的耐药性呈现上升态势,临床上应慎用抗菌药物,减少耐药菌株的产生。

Objective To study the pathogen distribution of chronic obstructive pulmonary disease（COPD） complicated with fungi infection and its susceptibility to several antifungal agents.Methods Clinical data of 82 patients with COPD accompanying fungal infection admitted to our hospital were retrospectively analyzed,including fungi identification and susceptibility test results.Results45 strains of Candida albicans,15 Candida tropicalis,11 Candida glabrata,8 Candida parapsilosis and 3 Candida krusei were detected out of the 82 patients.Yeast-like fungi showed higher sensitivity to 5-fluorocytosine and amphotericin B,but slightly lower sensitivity to Azoles.Conclusion Candida albicans are more common in COPD patients complicated with yeast-like fungal infections,and the detection rate of drug resistant strains shows a upward trend suggesting that the clinical use of antibiotics should be prudent in order to reduce the incidence of drug resistant strains.