某部队医院2013-2018年真菌血流感染菌种分布和耐药性分析

Distribution and drug resistance of fungal blood stream infections in a military hospital from 2013 to 2018

目的调查医院真菌血流感染状况,为真菌血流感染的预防和治疗提供参考。方法对某部队医院2013-2018年真菌血流感染的检测结果进行回顾性分析,对感染真菌种类、科室分布及耐药性状况进行分析。结果共分离真菌血流感染菌株97株,30. 93%为白色念珠菌,但由2013年的41. 67%,下降至2018年的27. 78%,呈现下降趋势。真菌血流感染的主要科室为血液科(24. 74%)和重症医学科(22. 68%)。97株真菌对4种抗菌药物的敏感率:氟胞嘧啶97. 80%、伏立康唑97. 80%、氟康唑93. 30%、伊曲康唑71. 10%。结论血流感染真菌以白色念珠菌为主,但非白色念珠菌感染有上升趋势;提高患者免疫力,减少有创性检查和治疗是减少真菌血流感染的重要环节;三唑类药是抗真菌药的主力军,在治疗过程中需要检测其耐药性的变化。

Objective To investigate the current fungal blood stream infections and to provide reference for the prevention and treatment of fungemia.Methods Retrospective analysis was used to test the results of fungal blood stream infections in a military hospital between 2013 and 2018.The species,distribution and drug resistance were analyzed.Results 97 strains of fungal blood stream infections were isolated,mainly Candida albicans(30.93%),but the proportion decreased(from 41.76%in 2013 to 27.78%in 2018).Fungal blood stream infections occurred most often in departments of hematology(24.74%)and intensive care medicine(22.68%).The sensitivities to four antimicrobial agents were as follows:5-fluorocytosine(97.80%),voriconazole(97.80%),fluconazole(93.30%),and itraconazole(71.10%).Conclusions Candida albicans is the main fungus associated with blood stream infections,but infections with non-Candida albicans are on the rise.Improving immunity and reducing invasive examination and treatment are important to reduce fungal blood flow in fection.Triazoles are still the mainstream antifungal drugs,and resistance needs to be tested in the course of treatment.