2017-2019年衡水市医院深部真菌感染致病菌分布及耐药性分析

Analysis of the distribution and drug resistance of pathogenic bacteria in deep fungal infections in Hengshui City from 2017 to 2019

目的了解衡水市医院深部真菌感染临床特点、致病菌分布及耐药性特点。方法回顾性分析2017年1月—2019年7月衡水市4家医院临床确诊深部真菌感染的560例患者临床资料、临床真菌分离和药敏相关数据,分析真菌的分布特征及其对常用抗真菌药的耐药率。结果560例患者中,男性、居住在乡村、夏秋季入院患者的分离率显著大于女性、居住在城市、春冬季入院的患者。感染部位以呼吸系统、泌尿系统和创伤部位等常见,主要分布于呼吸内科、重症医学科、肿瘤内科、泌尿外科和普通外科等临床科室。分离率居前5位的真菌分别为白色念珠菌、光滑念珠菌、热带念珠菌、曲霉菌和近平滑念珠菌。常见念珠菌对氟康唑的耐药率接近30%,曲霉菌对氟康唑耐药率超过90%。常见念珠菌和曲霉菌对伏立康唑、两性霉素B的耐药率小于10%。结论衡水地区深部真菌感染常见病原菌为白色念珠菌、光滑念珠菌、热带念珠菌、曲霉菌和近平滑念珠菌,曲霉菌对氟康唑耐药率高。

Objective To investigate the clinical characteristics,distribution of pathogenic bacteria and drug resistance characteristics of deep fungal infections in hospitals in Hengshui City.Methods Retrospective analysis of the clinical data,clinical fungal isolation and drug sensitivity data of 560 patients with deep fungal infections clinically confirmed by four hospitals in Hengshui City from January 2017 to July 2019 was conducted,and the distribution characteristics and the drug resistance profile of fungi were analyzed.Results Among the 560 patients,the isolation rates of males,those living in rural areas and admitted to hospital in summer and autumn were significantly higher than that of females,those living in cities and admitted to hospital in spring and winter.The infection sites were common in the respiratory system,urinary system and trauma,and were mainly distributed in clinical departments such as respiratory medicine,critical care medicine,oncology.urology and general surgery.The top 5 isolation rate of fungi were Candida albicans,Candida glabrata,Candida tropicalis,Aspergillus and Candida parapsilosis.The resistance rates of common Candida to fluconazole were close to 30%,and the resistance rate of Aspergillus to fluconazole was more than 90%.The resistance rate of common Candida and Aspergillus to voriconazole and amphotericin B was less than 10%.Conclusion The common pathogens of deep fungal infection in Hengshui area are Candida albicans,Candida glabrata,Candida tropicalis,Aspergillus and Candida parapsilosis.Aspergillus has a high resistance rate to fluconazole.