深部真菌感染的病原菌分布及药敏分析

Distribution and drug susceptibility of pathogenic bacteria causing deep fungal infections

目的分析医院无菌体液中深部真菌的分离率、菌种分布和耐药性,指导临床深部真菌的治疗。方法收集自2008年1月-2012年12月住院患者临床疑似感染标本,经萨布罗培养基分离培养真菌,科玛嘉显色培养基和VITEK-2Compact YST卡进行菌种鉴定,Rosco纸片扩散法测定药敏。结果 25 420份无菌体液标本中共分离出真菌340株,分离率为1.34%,其中白色假丝酵母菌140株占41.18%,光滑假丝酵母菌60株占17.65%,近平滑假丝酵母菌42株占12.35%,热带假丝酵母菌40株占11.76%,对氟康唑的敏感性分别为88.60%、63.30%、47.60%、80.00%,而对两性霉素B和制霉菌素的敏感性均为100.00%。结论医院深部真菌感染的病原菌以白色假丝酵母菌为主,近平滑假丝酵母菌、热带假丝酵母菌和光滑假丝酵母菌次之,白色假丝酵母菌和热带假丝酵母菌对唑类药物敏感性较高,近平滑假丝酵母菌和光滑假丝酵母菌对唑类药物的耐药率较高,两性霉素B和制霉菌素的抗菌活性最强。

OBJECTIVE To observe the isolation rate, distribution, and drug resistance of the species of fungi isolated from aseptic body fluid so as to guide the clinical treatment of deep fungal infections. METHODS The specimens were collected from the patients with suspected infections who were hospitalized from Jan 2008 to Dec 2012 ,then the fungi were isolated and cultured through Sobaurand＇s agar culture medium, the species of fungi were identified with the use of CHROMager medium as well as VITEK 2 Compact YST card, finally the drug susceptibility was determined by using Rosco disk diffusion method. RESULTS Totally 340 strains of fungi were isolated from 25 420 aseptic body fluid specimens with the isolation rate of 1.34%, among which there were 140 （41.18%） strains of Candidaalbicans, 60（17.65%） strains of Candidaglabrata, 42（12.35%） strains of Can dida parapsilosis, and 40 （11. 76%） strains of C. tropicalis. The drug susceptibility rates to fluconazole were 88.60%, 63. 30%, 47.60%, and 80. 00%, respectively, however, the drug susceptibility rates to both amphotericin B and nystatin were 100. 00%. CONCLUSIONS The C. albicans is the predominant species of pathogen causing deep fungal infection, followed by C. parapsilosis,C, tropicalis and C. glabrata. C. albicans and C. tropicalis are highly susceptible to azoles, while the C. parapsilosis and C. glabrata are highly resistant to azoles; the amphoteriein B and nystatin have the most powerful antibacterial activity.