老年患者感染假丝酵母菌的耐药性分析

Drug resistance analysis of candida albicans in the elderly patients

目的了解老年患者感染假丝酵母菌的菌群分布、耐药性及交叉耐药情况。方法对从老年住院患者分离出的136株假丝酵母菌进行药敏及交叉耐药分析。结果感染率居前三位的假丝酵母菌分别为白假丝酵母菌(50.74%)、光滑假丝酵母菌(19.85%)、热带假丝酵母菌(18.38%)。假丝酵母菌最常见感染部位为呼吸道,占86.76%。分离率较高的白假丝酵母菌、光滑假丝酵母菌、热带假丝酵母菌对两性霉素B、5-氟胞嘧啶的敏感率均在90%以上;三唑类药物中伏立康唑的敏感性最高,伊曲康唑的敏感率最低;氟康唑与伊曲康唑之间的交叉耐药率最高,为100%,氟康唑与伏立康唑之间的交叉耐药率为38.89%。结论假丝酵母菌属对三唑类药物的敏感性存在较大差异,三唑类药物之间存在严重的交叉耐药现象,临床治疗应依据药敏结果合理选择药物。

Objective To understand the distribution, drug sensitivity and across resistance of candida in the elderly patients. Methods The sensitivity and across resistance of 136 candida isolated from elderly patients. Results The top third of the candida isolated from elderly patients were candida albicans （ 50. 74% ）, candida glabrata （ 19. 85% ） and candida tropicalis （ 18.38% ）. The most common area of candida infection（86.76% ） was respiratory tract. The sensitivity rates of candida albicans, candida glabrata, and eandida tropicalis to amphotericin and flucytosine were from 90% to 100%. The sensitivity rate of voriconazole was the highest, and itraconazole was the lowest among the triazole. The rate of across resistance between fluconazole and itraconazole was 100% , but only 38.89% between flucon- azole and voriconazol. Conclusion There were greater differences among triazole sensitivity of candida, and there was eommonly across resistance between fluconazole and itraconazole. Selection antifungal drug according to sensitivity test result is very important to clinical treatment.