57例真菌血流感染的病原菌分布和药物敏感性分析

Pathogen distribution and drug resistance analysis of fungemia:a study of 57 cases

目的了解2010~2011年该院引起真菌血流感染的病原菌分布和药敏特点。方法患者静脉血经BACTEC 9120血培养仪培养后,直接镜检为真菌的阳性标本转种至沙保罗培养基,菌种分纯后使用科玛嘉显色培养基进行菌种鉴定,采用ATB-FUNGUS3试剂条进行药敏测定。结果血培养所检出的57株真菌均为念珠菌,其中白色念珠菌是主要病原菌,占52.6%,其次为光滑念珠菌26.3%、热带念珠菌12.3%、其他念珠菌7.0%和近平滑念珠菌1.8%。这些真菌血流感染的患者主要来自干部病房和ICU,以老年患者居多。所有菌株对两性霉素B、5-氟胞嘧啶及伏立康唑均敏感,仅1株光滑念珠菌对伊曲康唑耐药,同时对氟康唑呈剂量依赖性敏感。结论致血流感染的真菌以白色念珠菌为主,绝大部分念珠菌对抗真菌药物具有较高的敏感性。故加强病原学监测,及时作出早期诊断以及早期的经验性治疗等可以提高患者的生存率。

Objective To investigate the pathogen distribution and drug resistance of fungemia during year 2010to 2011in our hospital.Methods Blood was inoculated in blood culture vials and detected by BACTEC 9120blood culture system.Positive vials which identified with fungal growth by microscope were inoculated on SDA medium.Use CHROMagar medium to identify the fungi and ATB-FUNGUS3to do the drug susceptibility test.Results All the 57fungi isolated from the blood vials are candida spp.There were 30 Candida Albicans（52.6%）,15 Candida Glabrata（26.3%）,7 Candida Tropicalis（12.3%）,4other Candida（7.0%）,1 Candida Parapsilosis（1.8%）.These patients mainly came from Cadre ward and ICU,most of them are aged patients.All the strains were susceptible to Amphotericin B,5-Flucytosine and Vericonazole.Only one Candida Glabrata were resistant to Vericonazole,and dose dependent susceptible to Fluconazole.Conclusion The main pathogen of fungemia is Candida Albicans.Most of the candidas are susceptible to antifungal drugs.Intensifying the pathogen surveillence,making an early diagnosis and early experience antifungal therapy are more important to reduce the mortality of fungal infection.