喀什地区真菌感染现状及耐药特点分析

Analysis of fungal infection status and drug resistance in Kashi

目的分析喀什地区真菌感染的分布情况以及耐药性特点,为临床治疗真菌感染提供参考依据。方法回顾性分析2013年1月-2015年12月自新疆喀什地区分离出的780株真菌菌株,应用VITEK MS对其鉴定到种,念珠菌属利用ATBFUNGUS3真菌药敏板条进行MIC法药敏试验。应用WHONET 5.6软件分析三年来的真菌检出率变化,以及标本来源、病区分布和耐药性特点。结果 2013年1月-2015年12月,真菌感染标本检出率呈现出逐年增高趋势;标本来源呼吸道标本占43.33%,尿液标本占40.26%;真菌感染病区分布重症监护病房(ICU)占40.26%;呼吸科占26.92%。780例真菌感染中,白色假丝酵母菌检出最多,占46.41%,其次是光滑假丝酵母菌(20.26%)。734株念珠菌属对两性霉素B、5-氟胞嘧啶、伏立康唑的敏感性最高,对伊曲康唑的敏感性较差。结论真菌感染部位以呼吸道为主,真菌感染以念珠菌属多见,临床治疗中应加强真菌感染的耐药监测,指导临床合理用药,以提高临床疗效。

Objective To analyze the distribution and drug resistance of fungal infections in Kashi,so as to provide reference for the clinical treatment of fungal infections. Methods A retrospective analysis was performed on the 780 fungal strains from January 2013 to December 2015 separated from Kashi area,Xinjiang during January 2013-December 2015. Species of the strains were identified using VITEK MS. Candida was conducted for MIC drug susceptibility test with ATBFUNGUS3 antifungal susceptibility strip. WHONET 5. 6 software was used to analyze the changes of fungal detection rate in the past three years,as well as the source,distribution and drug resistance characteristics of fungi. Results During the January 2013-December2015,the detection rate of fungal infection specimens showed a trend of increase annually; respiratory tract specimens accounted for 43. 33%,urine samples accounted for 40. 26%,fungal infection in ICU ward accounted for 40. 26%; the Department of Respiration accounted for 26. 92%. Among the 780 cases of fungal infection,Saccharomyces albicans were the most,accounting for 46. 41%,followed by Candida glabrata（ 20. 26%）. The sensitivity of 734 strains of Candida to amphotericin B,5-flucytosine,voriconazole was the highest,and that to itraconazole was poor. Conclusion The main site of fungal infection is respiratory tract,and fungal infection is mainly caused by Candida. Clinical treatment should strengthen the monitoring of resistance to fungal infection,and guide the rational use of drugs in clinical,in order to improve the clinical efficacy.