综合医院住院患者口腔念珠菌分离株对抗真菌药物的敏感性研究

Antifungal susceptibility of oral Candida species isolated from hospitalized patients in a tertiary hospital in China

目的了解综合医院口腔念珠菌感染与带菌者分离菌株对抗真菌药物的耐药现状,为临床预防和治疗念珠菌感染提供参考。方法选择昆明医科大学第一附属医院多科室同期住院患者口腔分离的念珠菌菌株242株,采用微量稀释法(参照美国国家临床实验标准化委员会(NCCLS)推荐的M-27A方案)测定临床菌株对氟康唑、伊曲康唑、伏立康唑及两性霉素B的敏感性。结果白念珠菌对氟康唑、伊曲康唑、伏立康唑及两性霉素B的耐药率分别为9.20%、10.34%、5.75%及0%,非白念珠菌组对氟康唑、伊曲康唑、伏立康唑的耐药率分别为39.70%、11.76%、7.35%,1株光滑念珠菌对两性霉素B耐药。结论白念珠菌对唑类抗真菌药有一定的耐药性,无两性霉素B耐药;非白念珠菌对唑类抗真菌药耐药比例高于白念珠菌,尤其是对氟康唑,少数非白念珠菌对两性霉素B出现耐药性,应引起临床重视。

Objective To know the anti-fungal susceptibility of Candida species isolated from patients with oral Candidiasis and Candida carrier,monitor the Candida species resistance to commonly used anti-fungal drugs. Methods The susceptibility to fluconazole, itraconazole, voriconazole and amphotericin B of 242 Candida strains which were isolated from 80 oral candidiasis and 148 Candida carriers was evaluated by using the reference broth microdilution method in document M27-A2 of the Clinical and Laboratory Standards Institute. Results The antifungal susceptibility test showed most candida albicans isolates were sensitive to all anti-fungal drugs. Non-candida albicans candida(NCAC) species likely had lower sensitivity to Fluconazole than candida albicans, the statistic difference was significant(P<0.05). The resistance to fluconazole, itraconazole, voriconazole of Candida albicans strains were 9.20%, 10.34%, 5.75% respectively, no Candida albicans strain had resistance to amphotericin B. There were 39.70%, 11.76%, 7.35% of non-candida albicans Candida strains had resistance to fluconazole, itraconazole, voriconazole, and one Candida glabrata stain resistant to amphotericin B. ConclusionMost oral Candida isolates from hospitalized patients were sensitive to fluconazole, itraconazole, voriconazole and amphotericin B, but the resistance to azoles anti-fungal drugs had been detected. NCAC likely had higher resistance to Fluconazole, and a few strains emerged resistance to amphotericin B.