恶性肿瘤患者侵袭性真菌感染菌种分布及耐药性分析

Resistance analysis and genus distribution of invasive fungal infections in patients with cancer

目的分析肿瘤患者合并侵袭性真菌感染的临床状况、病原菌菌群分布及耐药情况,为临床治疗及减少真菌感染提供参考依据。方法回顾性分析3年来真菌培养阳性住院患者病例资料,从感染部位、菌种分布、耐药情况等方面进行分析。结果 1 158例肿瘤患者,发生院内侵袭性真菌感染患者数为117例(发生率为10.1%);痰液、分泌物、尿液标本来源分别占69.2%、12.8%、6.8%;假丝酵母菌是真菌感染主要菌属(94.3%),白念珠菌占72.6%,是感染主要菌种;其他为曲霉菌及隐球菌。5种常见抗真菌药物敏感率最高的是两性霉素(100%),其次为伏立康唑;光滑念珠菌及热带念珠菌耐药比较严重,伊曲康唑的敏感率分别为12.5%、45.0%,氟康唑(FLU)的敏感性分别为37.5%、60.0%。结论白念珠菌是肿瘤患者真菌感染的主要病原菌;两性霉素及伏立康唑对5种念珠菌有较好的抗菌活性。

Objective To investigate the current clinical features,genus characteristics and distribution of invasive fungal infections in ICU and provide a reference for clinical treatment and reduction of invasive fungal infections. Methods Retrospective study was performed on fungus-positive cases in 3 years with regard to the infected locations,species distribution and drug resistance. Results The rate of invasive fungal infection was 10. 1% in ICU. Isolating rate from sputum and urine accounted for 72. 6% and 6. 8% respectively. The most common pathogen was Candida,accounting for 94. 3%,among which Candida albicans accounted for 72. 6%. The susceptibility rates to amphotericin was the highest( 100%),followed by voriconazole. Conclusion The rate of invasive fungal infections increased in recent years in ICU and Candida albicans are still the main pathogens; Amphotericin and voriconazole have good antibacterial activity to five kinds of Candida.