老年住院患者口腔真菌定植状况及药敏研究

Study on oral fungal colonization and drug sensitivity in elderly inpatients

目的研究老年住院患者真菌定植及分布情况,分析真菌定植的高危因素及药敏情况,指导真菌感染的防治。方法采用口腔黏膜拭子法,对248例老年住院患者进行取材,采用CHROMagar念珠菌显色培养基及API 20C AUX酵母菌鉴定系统对念珠菌进行培养、分离、纯化和鉴定。采用肉汤微量稀释法进行抗真菌药物敏感性试验。结果老年住院患者口腔定植真菌共有111株,白念珠菌占95.5%,光滑念珠菌占4.5%。义齿佩戴、抗生素使用天数和糖尿病史与口腔真菌定植有显著相关性(P <0.05);白念珠菌对伊曲康唑耐药率为94.33%,两性霉素B为43.4%。光滑念珠菌对两性霉素B的耐药率为20%。结论老年住院患者最常见的口腔定植真菌是白念珠菌,主要危险因素是义齿佩戴、抗生素使用天数和糖尿病史,其敏感药物是氟康唑和伏立康唑。

Objective Though study the colonization and distribution of fungi in hospitalized elderly patients, and analysis of the risk factors and drug susceptibility of fungal colonization. To guide the prevention and treatment of fungal infections. Methods 248 elderly inpatients in Department of Cadre Recuperation were recruited. The oral samples were collected using the mucosal swab method. Then the Candida species were isolated by the CHROMagar Candida (CA), and identified by the API 20C AUX yeast identification system. Meanwhile, we performed an antifungal drug sensitivity test using broth micro dilution method. Results In the group of elderly hospitalized patients, two kinds of fungal species were isolated from a total of 111 strains. Of these two species, Candida albicans was dominant (95.5%). The only non-albicans Candida species detected was C. glabrata,(4.5%). Denture wearing, the days of antibiotics usage and diabetes history were significantly correlated to the oral fungal colonization in elderly inpatients (p<0.05).The drug resistance rate of candida albicans to itraconazole was 94.33%, and that of amphotericin B was 43.4%. The drug resistance rate of candida lucidum to amphotericin B was 20%. Conclusion C.albicans is the most common fungus in elderly inpatients. Denture wearing, the days of antibiotics usage and diabetes history are the high risk factors of oral fungal colonization in elderly inpatients. The fungi in the group of elderly inpatients are sensitive to fluconazole and voriconazole.