某院无菌体液念珠菌感染及耐药分析

Candida Infection and Drug Resistance of Sterile Body Fluid in A Hospital

目的:分析近年来笔者医院无菌体液中念珠菌感染的种类、临床分布及药敏情况,为临床医生抗真菌治疗提供依据。方法:收集福建中医药大学附属人民医院2015年1月-2019年12月自临床患者无菌体液中分离的念珠菌403株,对其菌种分布及药敏情况进行回顾性分析。结果:在分离出的403株念珠菌标本中,分离率前五位的菌种分别为白念珠菌(48.1%)、近平滑念珠菌(15.9%)、热带念珠菌(15.4%)、光滑念珠菌(14.6%)及克柔念珠菌(3.2%)。念珠菌分离率前三位的无菌体液类型为尿液(74.9%)、血液(8.4%)、胸水(5.0%)。念珠菌分离率前三位的科室分别为重症医学科(19.4%)、泌尿外科(12.4%)、肺病科(10.4%)。403株菌对5-氟胞嘧啶、两性霉素B、氟康唑、伏立康唑、伊曲康唑的敏感性分别为98.2%、100%、93.1%、95.3%、92.1%,未发现对两性霉素B耐药的菌株。结论:分离自临床患者无菌体液中的念珠菌以白念珠菌为主,其次为近平滑念珠菌、热带念珠菌,念珠菌抗真菌药物有较高的敏感性,临床应合理选用抗真菌药。

Objective:To analyze the types,clinical distribution and drug sensitivity of candida infection in sterile body fluids in the author’s hospital in recent years,to provide the basis for antifungal therapy for clinicians.Method:A total of 403 candida strains isolated from sterile body fluids of clinical patients in the People’s Hospital Affiliated to Fujian University of Traditional Chinese Medicine from January 2015 to December 2019 were collected,the strain distribution and drug sensitivity were analyzed retrospectively.Result:Among the 403 strains isolated,the top five strains were Candida albicans (48.1%),Near-smooth Candida (15.9%),Tropical Candida (15.4%),Smooth Candida (14.6%) and Croc Candida (3.2%),respectively.The top three sterile fluid types in candida isolation rate were urine (74.9%),blood (8.4%) and pleural fluid (5.0%).The top three departments of Candida isolation rate were ICU (19.4%),Urology (12.4%) and Pulmonary (10.4%).The sensitivity of 403 strains to 5-flucytosine,Amphotericin B,Fluconazole,Voriconazole and Itraconazole was 98.2%,100%,93.1%,95.3% and 92.1%,respectively.No amphotericin B resistant strain was found.Conclusion:The candida albicans isolated from the sterile body fluids of clinical patients are mainly Candida albicans,followed by Near-smooth candida and Tropical Candida.Candida antifungal drugs are highly sensitive,so antifungal drugs should be selected reasonably in clinical practice.