2010—2014年解放军三一六医院念珠菌的分布及耐药性分析

Analysis on distribution and drug resistance of Candida sp. in 316 Hospital of PLA from 2010 to 2014

目的分析2010—2014年解放军三一六医院念珠菌的分布及耐药性,为临床治疗念珠菌感染提供依据。方法对2010年1月—2014年12月解放军三一六医院分离出的913株念珠菌的菌种分布和耐药性进行回顾性分析。结果分离得到的913株念珠菌主要来自于内科住院患者,最常见的标本来源是痰液,构成比为89.1%;最常见的念珠菌是白色念珠菌,共分离到712株,占所有菌株的78.0%,其次是光滑念珠菌、热带念珠菌和克柔念珠菌,分别占所有菌株的10.8%、4.9%、4.5%。念珠菌感染患者中性别分布并无统计学意义,但65岁以上患者所占比例显著高于65岁以下患者所占比例(P<0.001)。药敏结果显示主要的念珠菌对5-氟胞嘧啶、两性霉素B和制霉菌素均有较高的敏感率,而对氟康唑、特比奈芬、伊曲康唑和伏立康唑的耐药率较高。结论念珠菌感染应该合理规范选用抗真菌药物,防止耐药念珠菌的出现。

Objective To analyze the distribution and drug resistance of Candida sp. in 316 Hospital of PLA from 2010 to 2014 and to provide the basis for clinical treatment. Methods The distribution and drug resistance of Candida sp. in 316 Hospital of PLA from January 2010 to December 2014 were analyzed retrospectively. Results A total of 913 strains of Candida sp. were isolated, and most of them were isolated from medical patients. Candida sp. was isolated mainly from sputum samples, and the constituent ratio was 89.2%. C. albicans（712 strains） predominated in the strains and constituted 78%. Followed by C. glabrata, C. tropicalis, and C. krusei, and accounted for 10.8%, 4.9%, and 4.5%, respectively. There was no significant difference between different genders, but significant higher incidence of candidiasis was found in adults aged ≥ 65 years old than adults aged〈 65 years old（P 〈0.001）. Susceptibility test results showed that main Candida sp. was sensitive to 5-flucytosine, amphotericin B, and nystatin, and the resistance rates of Candida sp. against fluconazole, terbinafine, itraconazole, and voriconazole were relatively high. Conclusion The infection of Candida sp. should be rational and standardized treatment with antifungal drugs to prevent the emergence of drug resistance.