念珠菌属176株的分离鉴定及其耐药性分析

Isolation and identification of 176 strains of Candida and its drug resistance analysis

目的了解医院常见酵母样真菌类型的分布特点及其对常见抗真菌药物的耐药性特点,为临床真菌感染性疾病提供病原学诊断和合理使用抗真菌药物的参考依据。方法采用常规培养分离念珠菌,用显色培养基和VlTEK 32全自动微生物分析仪鉴定念珠菌类型,并参照美国国家临床试验室标准化委员会(NCCLS)推荐的M27-A药敏试验方案的微量稀释法,应用氧化还原指示剂Alamarblue通过比色判定最小抑菌浓度(MIC)值,分别检测分离鉴定出的176株念珠菌属对4种抗真菌药物(氟胞嘧啶、伊曲康唑、两性霉素B、特比萘芬)的体外敏感性。结果在分离鉴定出的176株念珠菌中,白念珠菌114株(64.8%),热带念珠菌23株(13.1%),克柔念珠菌15株(8.5%),光滑念珠菌11株(6.3%),季也蒙念珠菌8株(4.5%),葡萄牙念珠菌5株(2.8%),176株临床分离的念珠菌对抗真菌药物的MIC值呈正态分布,其中白念珠菌对氟胞嘧啶、伊曲康唑、两性霉素B、特比萘芬的耐药率分别为9.6%,8.7%,7.0%,4.4%;热带念珠菌分别为13.0%,0,0,4.3%;克柔念珠菌分别为13.3%,6.7%,0,6.7%;光滑念珠菌分别为9.1%,9.1%,0,0;季也蒙念珠菌分别为12.5%,12.5%,0,12.5%;葡萄牙念珠菌分别为0,0,0,0。结论目前我院临床分离念珠菌中仍以白念珠菌为主,其次是热带念珠菌及克柔念珠菌,比色微量稀释药敏试验方法有较好的可重复性和稳定性,且简单省时,目前常用的抗真菌药对念珠菌属均有良好的体外抑菌作用,均未产生明显的耐药性。

Objective To investigate the kinds of candida causing hospital infection and drug resistance ,to provide guideline of etiologic diagnosis and suitable antifungal medication for clinical infectious diseases .Methods A total of 176 strains of Candida were isolated and identified ,the antifungal susceptibilities to 4 kinds of anti-fungus drug of 176 Candida isolates were assessed by the NCCLS standard method （M-27A） .The minimum inhib-itory concentrations （MICs） of 4 kinds of anti-fungus drug were determined by Alamarblue （oxidoreduction Indica-tor） .Results Among them ,Candida albicans accounted for 64.8 % （114 strains） ,c .tropicalis 13.1 % （23 strains） ,c .krusei 8 .5 % （15 strains） ,c .glabrata 6.3 % （11 strains） ,Monilia guilliermondii 4.5 % （8 strains） , Candida lusitaniae 2.8% （5 strains） ,the resistance rates of the Candida to flucytosine ,itraconazole ,amphotericine B and Terbinafine were from 0 to 13.3% .Conclusion The pathogens causing fungus infection in our hospital are mainly Candida albicans .The colorimetric system and the reference microbroth method ,performed according to NCCLs guidelines ,are reproducible and stable .Their resistance characteristics to 4 kinds of anti-fungus drug are relatively weaker ,the 4 kinds of anti-fungus drug are active against Candida .