肿瘤患者放化疗后真菌感染及耐药分析

目的了解肿瘤患者放化疗后真菌感染情况及对常用抗真菌药物的耐药情况。方法对我院送检的痰液、胸腹水、尿液、粪便、血液等522例患者真菌培养及药敏试验结果进行分析。结果522例患者共检出真菌71株，阳性率为13.6%（11.2%-16.0%），其中以白色念珠菌最为常见，占66.2%。药敏结果表明，本组真菌对所试药物伊曲康唑（ITO）、两性霉素B（AMB）、制霉菌素（NYS）、益康啶（ECO）、酮康啶（KET）、咪康唑（MIC）均有不同程度的耐药，尤其是ECO和KET，耐药率高达21.1%和25.4%，NYS和MIC的耐药率也在10%以上。结论掌握肿瘤患者治疗过程中引起真菌感染的病原菌及耐药情况，可指导临床合理用药。

Analysis of drug resistance of fungal infection of cancer patients after chemotherapy of radiotherapy

Objective To investigate the incidence, distribution of fungal infection and susceptibility to antifungal agents in cancer patients who have been treated by radiotherapy and （or） chemotherapy. Methods A total of 522 clinical samples of phlegm, urine, stool, and blood were collected from these cancer patients and cultured f fungal infection. Their resistance to antifungal agents was analyzed. Results The incidence of fungal infection was 13.6% among all the samples. Monilia was the major fungus and accounted for 66. 2%（47/71）. All fungi showed high resistance rate to various antifungal agents such as itraconazole （ITO）, amphotericin B （AMB）, nystatin （NYS）, enconazole （ECO）, ketoconazole （KET） ,miconazole （MIC）, ect. Especially for ECO and KET, the resistance rates were as high as 21.1 and 25.4% respectively. The resistance rates to NYS and MIC were over 10%. Conclusion Observation and control of the status of fungal infection and susceptibility to antifungal agents in cancer patients can provide the foundation for clinical rational use of antifungal agents.