深部真菌感染动态变化分析

Dynamic change of deep fungal infections

目的了解近5年医院深部真菌感染的动态变化趋势,为临床诊治及医院感染控制提供依据。方法对2007-2011年真菌检出情况、真菌的临床标本、真菌种类及真菌的耐药性进行分析。结果 5年真菌在临床病原菌中所占比例由2007年的7.8%上升至2011年的26.2%;临床标本以呼吸道标本居多,占82.7%,其次是尿液标本,占8.3%;感染的菌种仍以白色假丝酵母菌为主,其构成比由2007年的50.8%上升至2011年的66.3%,光滑假丝酵母菌则由2007年的20.6%下降至13.1%;伊曲康唑对光滑假丝酵母菌的耐药率逐年上升,已>30.0%,白色假丝酵母菌和热带假丝酵母菌耐药率较低。结论医院真菌感染呈上升趋势,应该加强对住院患者的真菌鉴定和药敏试验,合理使用抗真菌药物,减少院内真菌感染。

OBJECTIVE To understand the trend of dynamic change of deep fungal infections in recent five years so as to guide the clinical treatment and control of nosocomial infections. METHODS From 2007 to 2011, the detection rates of the fungi, clinical specimens, species of fungi, drug resistance were analyzed. RESULTS During the past five years, the proportion of fungi in the clinical isolates of pathogens increased from 7.8% in 2007 to 26.2% in 2011. 82.7 ~ of the clinical specimens were obtained from the respiratory tract specimens, 8.3% from the urine specimens. The Candida albicans was the predominant species of pathogen, with the constituent ratio increasing from 50.8% in 2007 to 66.3% in 2011, and the constituent ratio of the Candida glabrata decreased from 20.6% in 2007 to 13. 1%. The drug resistance rate of the C. glabrata to itraconazole increased year by year, having reached more than 30.0%, and the drug resistance rates of C. albicans and Candida tropicalis were relatively low. CONCLUSION The incidence of nosocomial fungal infections shows an upward trend, it is necessary to enhance the identification of fungi from the hospitalized patients, perform the drug susceptibility testing, and reasonably use antibiotics so as to reduce the incidence of nosocomial fungal infections.