1135株临床念珠菌分布特征和药敏结果分析

Strain distribution and drug susceptibility results analysis of 1135 Candida strains

目的 探讨本院2012年1月-2014年10月念珠菌感染特点及耐药情况,为临床合理使用抗真菌药物提供病原学依据。方法 应用回顾性调查分析的方法,统计本院2012年1月-2014年10月期间送检标本中分离的1 135株念珠菌,并对常用抗真菌药敏试验结果分析。结果 1 135株念珠菌以白念珠菌为主要致病菌,其次为热带念珠菌、光滑念珠菌、近平滑念珠菌、克柔念珠菌;主要来源于老年人,不同年龄分段念珠菌分布有明显差异（P〈0.05）;男性多于女性,男、女性别间分布有统计学差异（P〈0.05）;以痰标本最多,尿液次之,血液占第3位,不同标本来源分布有明显差异（P〈0.05）;念珠菌感染疾病主要来自消化内科疾病和肺部疾病,不同临床疾病类型间有明显差异（P〈0.05）;不同念珠菌对氟康唑、伏立康唑、伊曲康唑、两性霉素B的药敏敏感程度具有明显统计学差异（P〈0.05）,对氟胞嘧啶药敏敏感程度没有明显差异（P〉0.05）。结论 本院念珠菌感染最常见的为白念珠菌,其次为热带念珠菌。在治疗老年患者和肺部疾病患者,要警惕发生念珠菌等二重感染,一旦发生,要应及时对送检标本进行真菌培养和药敏试验,合理使用抗真菌药物,减少医院感染、多重耐药和深部真菌感染的发生。

Objective To explore the characteristics and drug resisitance of Candida infection in our hospital from Jan.2012 to Oct.2014,to provide aetiological basis for clinical rational use of antifungal agents. Methods Retrospective investigation and analysis method were used in this study.Results A total of 1 135 Candida strains were detected,most of which were C. albicans , followed by C. tropicalis , C. glabrataa , C. para psilosis and C. krusei. Mainly from the older population, Candida distribution had obvious difference in differentage groups （P〈0.05） ;Men more than women （P〈0.05）.With sputum speci men was the most, urine second,blood in the third it showed obvious difference in specimen source distribution （P〈0.05）. Candida infections were mainly from patients with digestive diseases and lung disease.The sensitivity to flueonazol,voricon- azole, itraeonazole and amphoteriein B had statistically difference in different Candida （P 〈0.05） while the sensitivity to flu orouracil was not statistically significant （P〉0.05）.Conclusion Candida albicans is the main pathogen of fungal infection followed by tropical Candida.Elderly patients and lung disease patients should guard Candida infections.Fungal isolation,i dentifieation and efficacy monitoring are very important to guide clinical rational drug using.Clinical antifungal therapy should be based on the results of strain identification and antifungal susceptibility test.