念珠菌引起尿路感染的病原学分布与研究

Etiological distribution and study of urinary tract infection caused by Candida

目的研究念珠菌引起尿路感染中,念珠菌培养结果、分布及耐药情况,及时为抗真菌感染治疗提供依据。方法用梅里埃ATB、科玛嘉显色培养基,对清洁中段尿标本中的念珠菌进行鉴定及药敏试验。结果引起尿路感染的念珠菌主要来自于肿瘤科、血液科、肾内科。检出的102株念珠菌,主要是白色念珠菌、热带念珠菌、光滑念珠菌。白色念珠菌对常用抗真菌药物的耐药率:氟康唑为20.0%、5-氟胞嘧啶为9.1%、两性霉素B为16.4%、伊曲康唑为14.5%、伏立康唑为12.7%。结论目前治疗尿路感染的抗真菌感染的药物氟康唑、5-氟胞嘧啶、两性霉素B、伊曲康唑、伏立康唑均有较好的抗菌活性。加强念珠菌耐药性的检测,为临床提供合理用药依据,降低念珠菌的耐药率。

Objective To investigate the culture results,distribution and drug resistance of urinary tract infections caused by Candida,so as to provide basis for the in-time treatment of antifungal infection.Methods Identification and drug sensitivity test were conducted on Candida in clean midstream urine specimen by using Merieux ATB and Comaja chromogenic medium,and the results were analyzed retrospectively.Results Candida causing urinary tract infection mainly comes from the department of oncology,hematology and nephrology.102 strains of Candida were mainly Candida albicans,Candida tropicalis and Candida glabrica.The drug resistance rates of Candida albicans to commonly used antifungal agents were 20.0%for fluconazole,9.1%for 5-fluorcytosine,16.4%for amphotericin B,14.5%for itraconazole,and 12.7%for voriconazole.Conclusion Currently,among antifungal agents used to treat urinary tract infections,fluconazole,5-fluorocytosine,amphotericin B,itraconazole and voriconazole show good antibacterial activity.Strengthening the detection of Candida drug resistance could provide the basis for rational clinical drug use and reduce the drug resistance rate of Candida.