泌尿道念珠地丝菌感染分析

Analysis of urinary tract infection caused by Geotrichum candidum

目的分析泌尿道念珠地丝菌感染的临床和微生物学特征,为临床抗感染治疗提供依据。方法对3例念珠地丝菌泌尿道感染患者的临床资料进行分析,同时对尿培养分离的念珠地丝菌进行鉴定和药敏试验。结果3例念珠地丝菌感染患者均为老年、免疫力低下患者,尿液标本在沙保氏培养基、血平板35℃培养24h后可见直径2mm-5 mm的灰白色酵母样菌落。培养3d后可见直径10mm灰白色或乳酪色绒毛状、具有同心圆放射沟纹的菌落,菌落周围下沉于培养基表面。菌落涂片镜检为矩形的关节孢子。药敏结果显示,念珠地丝菌对5-氟脲嘧啶、两性霉素B、氟康唑、伊曲康唑、伏立康唑敏感,3例患者使用伏立康唑治疗后痊愈。结论念珠地丝菌尿路感染较为少见,结合菌落形态、镜下特征和生化反应可鉴别该菌,使用唑类抗真菌药物治疗效果良好。

Objective To analyze the clinical and microbiological characteristics of urinary tract infection caused by Geotrichum candidum and provide basis for clinical anti-infection treatment.Methods The clinical data of 3 patients with urinary tract infection caused by Geotrichum candidum were analyzed,and the identification and drug sensitivity test of Geotrichum candidum isolated from urine culture were carried out.Results All of the 3 cases were aged and with low immunity.The urine samples were cultured in Sabouraud medium and blood plate at 35℃ for 24 hours,and then there were 2 mm-5 mm diameter gray yeast like colonies.After 3 days of culture,10 mm gray white or cheese colored fluffy colonies with concentric radial grooves could be seen,and the colonies sank on the surface of the culture medium.Microscopically,the colonies were found to be rectangular arthrospores.The results of drug sensitivity showed that Geotrichum candidum was sensitive to 5-fluorouracil,amphotericin B,fluconazole,itraconazole and voriconazole.Conclusion Urinary tract infection caused by Geotrichum candidum is rare and the pathogens can be identified by the combination of colony morphology,microscopic characteristics and biochemical reaction.The effect of azole antifungal drugs is good for Urinary tract infection caused by Geotrichum candidum.