ICU患者肺部感染真菌分析与耐药性研究

Fungus distribution and drug-resistant test for patients with pulmonary fungal infections in ICU

目的探讨重症监护病房(ICU)患者肺部感染真菌的分布及耐药性,分析真菌种类及耐药性。方法选取2011年6月-2015年5月于六安医院ICU就诊的172例肺部真菌感染患者临床资料,病原菌分离鉴定按《全国临床检验操作规程》进行常规操作,药敏试验采用K-B纸片法,于MicroScan Waik-AWay-40全自动微生物分析仪进行药敏试验,结果判定参照美国临床实验室标准化研究所(CLSI)规定的标准。结果 172例患者痰液标本共分离真菌218株,以白色假丝酵母菌和热带假丝酵母菌为主,分别占40.37%和21.10%;218株真菌除对氟康唑和伊曲康唑敏感率<90.00%外,对氟胞嘧啶、两性霉素B和伏立康唑的敏感率分别为97.25%、98.62%和92.66%。结论白色假丝酵母菌是ICU肺部真菌感染的主要致病菌,可优先选择氟胞嘧啶、伏立康唑和两性霉素B进行治疗。

OBJECTIVE To investigate fungus distribution and drug-resistance for patients with pulmonary fungal infections in ICU and analyze fungal types and resistance.METHODS Totally 172 cases of patients with pulmonary fungal infections in ICU in our hospital from Jun.2011 to May 2015 were selected.Bacterial isolation and identification were carried out complying with National Guide to Clinical laboratory Procedures,drug sensitivity tests were performed with the MicroScan Waik-AWay-40full-automatic system and results were evaluated according to CLSI.RESULTS Totally 218 strains of fungi were isolated from 172 samples,and Candida albicans and Candida tropicalis were the main fungi,accounting for 40.37%and 21.10%,respectively.Besides of fluconazole and itraconazole with sensitive rates of 90.00%,the drug-sensitive rates against fluorocytosine,amphotericin B and voriconazole were 97.25%,98.62%and 92.66%,respectively.CONCLUSIONC.albicansis a major pathogen for pulmonary fungal infections in ICU,and fluorocytosine,voriconazole and amphotericin B are preferable for treatment.