侵袭性真菌感染可疑病原菌种分布及其耐药现状

Distribution and drug resistance of pathogenic species of invasive fungal infections

目的了解侵袭性真菌感染可疑病原菌种分布及其耐药现状。方法对2012年临床送检各类微生物学标本分离真菌的菌种分布及耐药现状进行统计分析。结果共分离出酵母样真菌320株,以念珠菌为主,呼吸道为其最主要的标本来源(占64.4%),分离自无菌体液等标本的共29株(占9.1%),6例念珠菌血症患者3例同时导管培养阳性。共分离出曲霉菌62株,未分离出接合真菌等其他丝状真菌。氟康唑耐药的念珠菌已达10%,其中热带念珠菌和光滑念珠菌对氟康唑的耐药率已接近甚至超过20%,近平滑念珠菌对其仍100%敏感。结论导管相关性血流感染(CRBSI)是念珠菌血症的重要来源。曲霉培养阳性,尤其是单次培养阳性不能排除上呼吸道定植。三唑类耐药的念珠菌已不罕见,临床应根据其耐药现状谨慎选择经验用药。

Objective To study the distribution and drug resistance of suspected pathogenic species of invasive fungal infections. Methods The distribution and drug-resistant status of fungi which were isolated from all kinds of clinical samples in 2012 were an- alyzed. Results 320 strains of yeast-like fungi were isolated,among which Candida was the main species. The main source of speci- mens was respiratory tract（64.4%）o 29 strains were isolated from sterile body fluids and other specimens（9.1%）. 6 strains were isolated from candidemia,in which 3 cases were catheter culture positive simultaneously. 62 strains of aspergillus were isolated. But there was no other kind of filamentous fungi isolated. Fluconazole-resistant Candida accasnted for 10%. The fluconazole-resistant rates of Candida tropicalis and Candida glabrata were closed to or above 20%. Parapsilosis was still 100% sensitive to flueonazol. Conclusion Catheter-related bloodstream infections（CRBSI） was an important source of candidemia. Aspergillus culture positive, especially single positive culture could not exclude the upper respiratory tract colonization. Triazole-resistant candida was not un- common, the drug for the treatment should be carefully chosen based on their current situation of drug resistance.