62例真菌菌血症回顾性研究

目的研究真菌菌血症临床特点、可能的相关因素、病原谱及药敏特点,为真菌菌血症防治提供依据。方法回顾性地研究医院2003-2004年发生的62例真菌菌血症。结果95.2%的真菌菌血症为医院感染;59例长期应用广谱抗菌药物(95.1%)、中心静脉置管(46.8%)、气管切开及机械通气(38.7%);分离出的病原菌依次为白色假丝酵母菌(16株)、近平滑假丝酵母菌(12株)、光滑假丝酵母菌(11株)、热带假丝酵母菌(10株);对氟康唑敏感性均>90%(热带假丝酵母菌除外)。结论非白色假丝酵母菌感染导致的真菌菌血症逐渐增多,广谱抗菌药物的应用及中心静脉置管与真菌菌血症相关性可能更强,氟康唑对除热带假丝酵母菌、克柔假丝酵母菌外的多种真菌有良好的抗菌活性。

Fungemia: A Retrospective Analysis of 62 Cases

OBJECTIVE To investigate the clinical characteristics,predisposing factors,pathogenicity and antifungal susceptibility of fungemia and to provide evidence for prevention and therapy.METHODS A total of 62 cases with fungemia were retrospectively analyzed which abtained from 2003 to 2004 in our hospital.RESULTS 95.2% of these cases were hospital-acquired infection.Fifty nine cases were associated with previous administration of broad-spectrum antibiotics(95.1%),central venous catherization(46.8%) and tracheotomy or mechanical ventilation(38.7%).Candida albicans comprised 16 cases of fungemia,followed by C.parapsilosis(12),C.glabrata(11),and C.tropicalis(10).The sensitivity rate to fluconazole of these first three species were all above 90% except C.tropicalis.CONCLUSIONS Our findings highlighted the incresing of fungemia caused by non-C.albicans yeast.Prior broad spectrum antibiotics use and central venous catheterization are significantly associated with fungemia.Fluconazole still keeps good antifungal activity to the species except C.krusei and C.tropicalis.