临床深部真菌感染分析

目的　了解医院内深部真菌感染现状和流行病学特征。方法　采用常规方法筛检、培养真菌 ,API 2 0C鉴定系统和MIC药敏检测 ;调查深部真菌感染的流行病学特征 ;对 38例反复感染者T细胞亚群和白细胞进行分析。结果　分离医院感染真菌 12 9株 ,医院感染率 8.4 %(12 9/15 30 )。白色念珠菌感染率最高 ,为 6 7%(87/ 12 9) ,其次为光滑念珠菌 (19.4 %)和热带念珠菌(8 5 %)。 6 5岁以上老年患者占真菌感染人数的 85 .3%(110 / 12 9) ;住院部呼吸科真菌感染率占全院总数的 6 4 .3%(83/ 12 9)。 38例免疫细胞分析 ,与 2 0例健康对照比较有非常显著性差异 (P <0 .0 1)。 12 9株真菌对二性霉素B、特比奈芬的耐药率分别达到 13.6 %和 38.6 %。结论　深部真菌感染显著增高 ,真菌检测对临床诊断、调整治疗方案、预后评估有重要临床意义。建议合理用药 ,对高危人群适当预防性治疗。实验室真菌检测面临方法改进和标准化。

An analysis on clinical infection by deep fungus

Objective To find out about the infection current condition by deep fungus in hospital and to investigate the epidemiological features of the fungus in hospital.Methods The routine examine and culture of fungus were used.The fungi were classified by API-20C and drug sensitivity test by MIC test.Meanwhile,the epidemiological features and susceptible factors to the fungus were determined.The WBC and T cell of the 38 patients infected repeatedly were detected .Results One hundred and twenty-nine strains were related to hospital infection.The positive rate of deep fungus was 8.4% .Candida albicans infection rate was as high as 67%,next was candida glabrata (19.4%) and tropicalis (8.5%).The elderly patients,over 65 years old hud highest infection rate(85.3%); and respiratory system was most infected (64.3%).An analysis of immunocyte in 38 cases was markedly different from 20 healthy volunteers (P<0.01).For these strains,the resistant rates to amphotericin B and terbinafin were 13.8% and 38.6% respectively.Conclusions The infection by deep fungus is clearly higher and the detection is useful for diagnosis,efficiency prognosis and therapeutic plan adjustment .The results suggest that antibiotics should be reasonably used and prevention for the high risk group should be given.Detection of fungus was faced with improvement and standardization.