医院内尿路真菌感染的菌群分布及耐药性分析

Bacterial distribution and drug resistance of hospital urinary tract fungal infections

目的探讨医院内尿路真菌感染的菌群分布及耐药性分析。方法对尿常规检测发现真菌阳性者以及疑似尿路感染者而进行专门中段尿培养的分离的真菌菌株共168株进行回顾性分析。结果 168株真菌中主要是白色假丝酵母菌占38.10%,其次是光滑假丝酵母菌占33.13%和热带假丝酵母菌占16.67%。168株真菌对5-氟胞嘧啶的耐药率均为0,对两性霉素B、氟康唑和伊曲康唑的耐药率分别为1.19%、10.12%和21.43%。伊曲康唑的耐药率明显高于5-氟胞嘧啶、两性霉素B和氟康唑(χ2=40.32、34.30、8.09,P<0.05或P<0.01)。结论医院内尿路真菌感染仍以白色假丝酵母菌、光滑假丝酵母菌和热带假丝酵母菌为主,对5-氟胞嘧啶、两性霉素B和氟康唑具有良好的敏感性,尤其是对5-氟胞嘧啶和两性霉素B的敏感性更佳,可作为尿路真菌感染的首选药物。

Objective To explore the bacterial distribution and drug resistance of hospital urinary tract fungal infec- tions. Methods 168 fungal strains, isolated from midstream urine culture of patients with positive fungi and sus- pected urinary tract infection by urine routine test, were given retrospective analysis. Results Among the 168 fun- gal strains, 38.10% were Candida albicans, 33.13% were Candida glabrata and 16. 67% were Candida tropica- lis, whose drug resistance rates were 0 to 5-Fluorocytosine, and I. 19%, I0. 12% and 21.43% to Amphoteric B Enzyme, Fluconazol and Itraconazole respectively. The drug resistance rates to hraconazole were much higher than to 5-Fluorocytosine, Amphoteric B Enzyme and Fluconazol （χ2 = 40. 32, 34. 30, 8.09, P 〈 0. 05 or P 〈 0. 01 ）. Conclusion Candida albicans, Candida glabrata and Candida tropicalis are still the major pathogenic bacteria in the hospital urinary tract fungal infections, and have favorable sensibility to 5- Fluorocytosine, Amphoteric B En- zyme and Fluconazol, especially the former two, which can be the first choice drug to treat urinary tract fungal in- fections.