80株深部真菌感染阳性血培养及药敏结果分析

Results of positive blood cultures and drugs susceptibility for deep fungi infections: Analysis of 80 cases

目的 分析 80株血培养真菌阳性标本及其药敏结果 ,寻找深部真菌感染特点。方法 血培养使用Back/Alert血培养仪。分离使用科玛嘉培养基。真菌和细菌鉴定使用VitekAMS 6 0微生物分析仪。药敏使用微量MIC法。HCMV检验使用PCR和RT PCR方法。结果 80株真菌分布在 4个菌属中 ,以念珠菌属为主占 91 2 5%。获得阳性结果时间平均 31 80h ,72h内获得结果者 76株占 95 0 %。对 5种真菌作药敏试验 ,5 氟胞嘧啶敏感率最高 ( 97% ) ,特比奈芬最低 ( 35% )。 51 2 5%( 4 1 /80 )患者从血以外的其他标本获得与血中分离菌种一致的真菌。 80例患者中 4 6例伴随有细菌或病毒感染 ,占患者57 50 %。真菌感染多见于免疫功能低下者 ,本组 80例患者中各种肿瘤占 6 9例 ( 86 2 5% )。结论 血培养阳性是患者深部真菌感染的确证依据 ,多为在免疫功能低下者发生的院内感染 ,多系统真菌感染多为临床致死原因。

Objective To explore the characteristics of deep fungi infections according to the results of positive blood cultures and drugs susceptibility of deep fungi infections in 80 cases.Methods Blood cultures were performed by Bact/Alert system.Fungi were cultured by CHR Magar medium.Identification of fungi and bacteria was performed by Vitek AMS system.The detection for fungi and drugs susceptibility test were carried out by MIC method.HCMV was detected by PCR or RT PCR.Results The fungi from positive blood cultures of 80 cases were involved with 4 species.Among them 91.25% belonged to Candida .The average time for positive results was 31.80 hours,76 positive results (95%) were achieved within 72 hours.In 51.25% of patients (41/80) positive results of fungi culture were also gained from other fluids besides blood samples and the species of fungi were consistent with thoes in blood cultures.Forty six patients (57.5%) were found bacteria or virus infection accompanied.Sixty nine patients (86.25%) were suffering from various tumors.Conclutions Positive results of fungi blood culture are reliable evidence of fungi infections.It easily occurs in the immunocompromised patients as nosocomial infection.Multisystemic fungi infections usually become the lethal reason.