沈阳市某三甲医院念珠菌感染病原学监测分析

Etiological surveillance and analysis of Candida infection in a grade 3 and first-class hospital in Shenyang

目的了解东北地区医院内念珠菌感染病原谱和临床分布特征,为预防本地区医院内真菌感染及早期诊断提供依据。方法采集2020年10月至2021年10月沈阳医学院附属中心医院住院患者送检真菌的各类标本。标本使用沙保氏培养基和念珠菌显色培养基进行培养,革兰染色初步筛选,VITEK 2 Compact全自动细菌鉴定及药敏分析仪进行菌种鉴定。结果送检各类标本有259例为念珠菌阳性结果,其中白色念珠菌检出最高(52.51%),其次为热带念珠菌(18.15%)和光滑念珠菌(16.60%)。不同临床病区念珠菌检出率不同,重症医学科(52.51%)、呼吸重症监护室(18.92%)和呼吸科(17.37%)最高。念珠菌检出最高的标本分别为痰液(50.19%)、便(26.25%)和尿液(17.76%)。212名念珠菌阳性患者中60岁及以上占95.75%。结论院内念珠菌感染以白色念珠菌为主,重症医学科和呼吸重症监护室患者检出念珠菌最多,呼吸道最易被念珠菌侵袭,老年人为易感人群。临床应持续对住院患者进行病原学监测,结合院内念珠菌感染的地域特点进行防治。

【Objective】To understand the composition of pathogen spectrum and clinical distribution characteristics of hospital Candida infections in Northeast China,so as to provide basis for the prevention and early diagnosis of hospital fungal infections in this region.【Methods】Various fungal samples were collected from inpatients in Affiliated Central Hospital of Shenyang Medical College from October 2020 to October 2021.Sabouraud's Medium and Candida chromogenic medium were used for culture,Gram stain was used for preliminary screening,and VITEK-2 compact automated bacterial identification and drug susceptibility analyzer were used for strain identification.【Results】A total of 259 samples were found to be positive results for Candida,among which Candida albicans was the highest(52.51%),followed by Candida tropicalis(18.15%)and Candida glabrata(16.60%).The detection rate of Candida was different in different clinical wards,with the highest in intensive care department(52.51%),respiratory intensive care unit(18.92%)and respiratory department(17.37%).The samples with the highest detection of Candida were sputum(50.19%),feces(26.25%)and urine(17.76%).95.75%of 212 Candidia positive patients were 60 years old or above.【Conclusion】Hospital Candida infection is mainly Candida albicans.Candida is most detected in patients in intensive care department and respiratory intensive care unit,and the respiratory tract is most susceptible to Candida.The elderly are susceptible groups.In the clinic,the etiological monitoring of hospitalized patients should be carried out,and the prevention and treatment should be carried out according to the regional characteristics of hospital Candida infections.