2015—2019年连云港市第二人民医院感染真菌患者菌株分布及耐药性分析

Analysis of bacterial strain distribution and drug resistance of fungal cultures from patients in the Second People’s Hospital of Lianyungang from 2015 to 2019

目的分析2015—2019年连云港市第二人民医院真菌培养阳性标本的病原菌分布情况和耐药状况。方法收集2015年1月—2019年12月在连云港市第二人民医院所有的真菌培养和药敏试验阳性的标本共663例,应用DL-96Ⅱ细菌测定系统的体外诊断试剂DL-96FOUNGUS对样本进行真菌鉴定,以5种常见抗真菌药物为例,采用MIC法开展对样本中已鉴定真菌的药物敏感性试验,并应用WHONET 5.6软件进行对于该试验结果的统计学分析。结果2015—2019年连云港市第二人民医院共分离出真菌663株。按照菌种类型分类,可得到如下比例:白色假丝酵母菌占49.9%(331/663)、热带假丝酵母菌占15.2%(101/663)、都柏林假丝酵母菌占8.3%(55/663)、光滑假丝酵母菌14.9%(99/663)、其他假丝酵母菌占11.6%(77/663)。白色假丝酵母菌对伏立康唑、氟康唑、伊曲康唑3种抗菌药物仍具有耐药性;热带假丝酵母菌对氟胞嘧啶、两性霉素高度敏感,对伏立康唑、氟康唑、伊曲康唑表现为耐药;光滑假丝酵母菌对氟胞嘧啶和两性霉素B的敏感性最高。结论白色假丝酵母菌、热带假丝酵母菌、光滑假丝酵母菌是真菌感染的主要常见致病菌,以热带假丝酵母菌为主的多种假丝酵母菌对于氟康唑、伊曲康唑等临床常用抗菌药物耐药性日渐增长。

Objective The distribution of pathogens and drug resistance of positive fungal culture specimens in the Second People’s Hospital of Lianyungang from 2015 to 2019 were analyzed.Methods A total of 663 fungal culture and drug sensitivity test positive specimens were collected from The Second People’s Hospital of Lianyungang from January 2015 to December 2019.The in vitro diagnostic reagent DL-96 FOUNGUS of DL-96Ⅱ bacterial determination system was used to identify the fungi in the samples.Taking 5 common antifungal drugs as examples,the MIC method was used to carry out drug sensitivity test of identified fungi in the samples,and WHONET 5.6 software was used for statistical analysis of the test results.Result According to the types of bacteria,the following proportion can be obtained:Candida albicans accounted for 49.9%(331/663),Candida tropicalis accounted for 15.2%(101/663),Candida Dublin accounted for 8.3%(55/663),Candida glabrata accounted for 14.9%(99/663),and other candida accounted for 11.6%(77/663).Candida albicans was still resistant to voriconazole,fluconazole,and itraconazole.Candida tropicali was highly sensitive to fluorocytosine and amphotericin,and showed resistance to voriconazole,fluconazole and itraconazole.Candida glabrata had the highest sensitivity to fluorocytosine and amphotericin B.Conclusion Candida albicans,Candida tropicalis,and Candida globulidis are the main pathogenic bacteria of fungal infection.The resistance of various candida strains,mainly the Candida tropicalis,to fluconazole,itraconazole,and other commonly used antibiotics in clinic is increasing day by day.