老年下呼吸道感染患者痰分离真菌种类及药物敏感性

Species and antimicrobial susceptibility of fungi isolated from sputum of elderly patients with lower respiratory tract infection

目的了解老年患者下呼吸道痰标本中真菌种类分布及药物敏感性,为预防真菌感染及针对性诊治提供依据。方法收集2010年1月—2014年10月云南亚高原地区3所医院老年患者下呼吸道标本分离的真菌,对其进行鉴定和药物敏感性试验。结果 1 887株真菌中,白假丝酵母菌最多,占65.18%,同时,分离出毛霉菌属（0.69%）、构巢曲霉菌（0.16%）等少见菌株;分离的菌株对制霉菌素、两性霉素B和伊曲康唑的敏感率较高,分别为100.00%、90.14%和88.98%;对氟康唑和咪康唑的耐药率较高,分别为34.29%和36.62%;5种常见酵母菌对制霉菌素均敏感,但白假丝酵母菌、光滑假丝酵母菌对氟康唑、咪康唑的耐药率达35.94%~40.88%,白假丝酵母菌对5-氟胞嘧啶的耐药率为19.51%。结论对老年人临床抗真菌治疗需要考虑真菌类别及药敏结果。

Objective To investigate the species distribution and antimicrobial susceptibility of fungi isolated from lower respiratory tract（LRT）sputum specimens of elderly patients,and provide evidence for preventing and treating fungal infection.Methods Fungi isolated from LRT specimens of elderly patients in3 hospitals in Yunna subplateau area between January 2010 and October 2014 were collected,identified and performed antifungal susceptibility testing.Results Of 1 887 fungal isolates,Candida albicans（C.albicans）accounted for 65.18%,Mucor（0.69%）,Aspergillus nidulans（0.16%）and other rare strains were isolated;the isolated strains were highly sensitive to nystatin（100.00%）,amphotericin B（90.14%）,and itraconazole（88.98%）;but had higher resistance rates to fluconazole（34.29%）and miconazole（36.62%）;five common Candidaspecies were all sensitive to nystatin,but resistance rates of C.albicans and C.glabratato fluconazole and miconazole were up to 35.94%-40.88%,resistance rate of C.albicans to 5-fluorocytosine was 19.51%.Conclusion Fungal species and antifungal susceptibility testing results should be considered in antifungal treatment for elderly patients.