下呼吸道真菌感染菌群分布及耐药性分析

Distribution and drug resistance of fungi causing lower respiratory tract fungal infections

目的明确临床住院患者下呼吸道真菌感染的菌群分布及其耐药特点,以指导临床合理用药。方法回顾性调查2009年1月-2011年12月医院下呼吸道痰标本分离出的真菌及其药敏率。结果共检出真菌514株,检出最高的分别是白色假丝酵母菌372株占72.37%、热带假丝酵母菌68株占13.23%、光滑假丝酵母菌26株占5.06%;主要分布在呼吸内科、ICU和重症监护病房;白色假丝酵母菌和热带假丝酵母菌对5种抗真菌药物的耐药率较低,均<30.00%;光滑假丝酵母菌和克柔假丝酵母菌对伊曲康唑的耐药率为92.31%、59.09%,克柔假丝酵母菌对氟康唑的耐药率较高,为86.36%。结论下呼吸道真菌感染以白色假丝酵母菌为主,各种真菌对5种抗真菌药物的耐药率不同,临床应参照药敏结果,并考虑每种抗真菌药物的特点,合理使用抗菌药物。

OBJECTIVE To determine the distribution and drug resistance of the pathogens causing lower respiratory tract fungal infections in the hospitalized patients so as to guide the reasonable use of antibiotics.METHODS The fungi isolated from the lower respiratory tract specimens from Jan 2009 to Dec 2011 were retrospectively investigated,and the drug susceptibility rates were analyzed.RESULTS A total of 514 strains of fungi were isolated,there were 372（72.37%） strains of Candida albicans,68（13.23%） strains of Candida tropicalis and 26（5.06%） strains of Candida glabrata.The isolated strains mainly distributed in the department of respiratory diseases,ICU and the departments with ICU.The drug resistance rates of C.albicans strains and C.tropicalis strains to 5 antifungal drug were less than 30.00%,the drug resistance rates of C.glabrata strains and C.krusei strains to itraconazole were 92.31% and 59.09%,respectively,and the drug resistance rate of C.krusei strains to fluconazole also was 86.36%.CONCLUSION C.albicans strains are the main species of fungi causing the lower respiratory tract infections,all the species of fungi vary in the drug resistance to 5 antifungal drugs.The antibiotics should be reasonably used on the basis of the result of drug susceptibility testing.