1015株念珠菌感染的病原菌分类和药敏分析

目的了解医院念珠菌感染的病原菌分类及对氟康唑的敏感性. 方法采用微量稀释法和改良纸片法测定临床标本分离的各类念珠菌对氟康唑的敏感性. 结果共分离出1 015株念珠菌,其中白色念珠菌占49.4%,热带念珠菌占19.1%,克柔念珠菌占10.1%,光滑念珠菌占10.5%,其他念珠菌占10.9%;对氟康唑的耐药率白色念珠菌为1.6%、热带念珠菌为0%、克柔念珠菌为25%、光滑念珠菌为40%、其他念珠菌为8.4%. 结论念珠菌在临床标本中的分布已发生变化,白色念珠菌比例下降但还是最常见念珠菌感染的病原菌,非白色念珠菌比例有所上升,氟康唑对白色念珠菌、热带念珠菌有极好的抗菌活性,而对克柔念珠菌、光滑念珠菌的抗菌活性较差,临床经验用药应依据药敏结果合理选用.     

European Confederation of Medical Mycology (ECMM) prospective survey of candidaemia: report from one Italian region

An ECMM epidemiological prospective survey of candidaemia was performed in one Italian region (Lombardy; population: 8 924 870) by the National Society of Medical Mycology (FIMUA) from September 1997 to December 1999. In total, 569 episodes were reported with an overall rate of 0.38/1000 admissions, 4.4/100000 patient days. Predisposing factors included presence of an intravascular catheter (89%), antibiotic treatment (88%), surgery (56%), intensive care (45%), solid tumour (28%), steroid treatment (15%), haematological malignancy (7%), HIV infection (6%), fetal immaturity (4%). Mucous membrane colonization preceded candidaemia in 83% of patients. Candida albicans was identified in 58% of cases, followed by Candida parapsilosis (15%), Candida glabrata (13%), Candida tropicalis (6%). Septic shock occurred in 95 patients. Crude mortality was 35%, the highest in C. tropicalis fungaemia (44%), the elderly (64%) and solid tumour cancer patients (43%). Intravascular catheter removal was associated with higher survival rate (71 vs. 47%). This survey underscores the importance of candidaemia in hospital settings.     

Synthesis and evaluation of novel 1-(1H-1,2,4-triazol-1-yl)-2-(2,4-difluorophenyl)-3-[(4-substitutedphenyl)-piperazin-1-yl]-propan-2-ols as antifungal agents

A series of 1-(1H-1,2,4-triazol-1-yl)-2-(2,4-difluorophenyl)-3-[(4-substitutedphenyl)-piperazin-1-yl]-propan-2-ols have been designed and synthesized on the basis of the structure-activity relationships and antimycotic mechanism of azole antifungal agents. Their structures were confirmed by elemental analysis, IR, MS, (1)H NMR and (13)C NMR. Results of preliminary antifungal tests against six human pathogenic fungi (Candida albicans, Candida parapsilosis, Cryptococcus neoformans, Candida tropicalis, inherently fluconazole-resistant Candida krusei, Candida glabrata) in vitro showed that all title compounds exhibited activity against fungi tested to some extent except against C. tropicalis. Compound 5b showed higher activity against C. albicans, C. parapsilosis and C. krusei than fluconazole, and its MIC values were determined to be 0.5microg/mL, 1microg/mL and 4microg/mL, respectively. Compound 5k showed higher activities against Torulopsis glabrata than fluconazole (with the MIC value of 2microg/mL). Compounds 5a, 5c, 5f, 5g, 5i exhibited higher activities against C. parapsilosis than fluconazole (with the MIC values of 2microg/mL, 2microg/mL, 2microg/mL, 1microg/mL and 2microg/mL, respectively).     

临床标本中假丝酵母菌属的检出率及耐药性分析

目的 了解医院假丝酵母菌属感染的临床分布及耐药率.方法 以萨布罗培养基分离真菌,用API 20 CAUX假丝酵母菌属鉴定板和ATB 3 Fungus假丝酵母菌属药敏板进行假丝酵母菌属的鉴定和药敏检测.结果 共分离假丝酵母菌属189株,检出率为9.6％,以白色假丝酵母菌的检出率居首位,占76.2％,其次为热带假丝酵母菌、光滑假丝酵母菌、近平滑假丝酵母菌,分别占8.5％、6.3％、5.3％;189株假丝酵母菌属所致的临床感染,主要为肺部感染,痰标本中共检出114株,占60.3％,其次为清洁中段尿、粪便,分别占15.3％、9.0％;189株假丝酵母菌属对5-氟胞嘧啶、两性霉素B、伏立康唑的敏感率较高.结论 必须重视假丝酵母菌属的培养鉴定和药敏试验,以指导临床合理使用抗真菌药物.     

血流感染假丝酵母菌菌种构成及其药物敏感性

目的分析某院假丝酵母菌血流感染菌种构成及其对抗真菌药物的敏感性,为临床预防和治疗假丝酵母菌血流感染提供依据。方法回顾性分析2009-2013年该院临床科室送检血标本中检出的假丝酵母菌,并对假丝酵母菌血流感染的高危因素进行分析。结果2009-2013年42例患者血标本分离假丝酵母菌42株,以近平滑假丝酵母菌为主（20株,47.62%）,其次为白假丝酵母菌（16株,38.10%）、热带假丝酵母菌（4株,9.52%）、光滑假丝酵母菌（2株,4.76%）。来源科室主要为：急诊监护病房（EICU,11株）、泌尿外科（9株）、心胸外科（8株）等。37例（占88.10%）患者静脉导管与血标本培养出相同的假丝酵母菌,留置静脉导管至血培养阳性和导管培养阳性的平均时间分别为31.47 d和33.18 d;导管和血培养阳性比例随着置管时间的延长均呈上升趋势（均P＜0.001）。检出的假丝酵母菌对氟康唑、伏立康唑的敏感率均为75.00%～100.00%,对两性霉素B的敏感率均为100.00%;而不同菌种对伊曲康唑的敏感率存在较大差异（0～87.50%）。结论该院假丝酵母菌血流感染菌株以近平滑假丝酵母菌为主,且与静脉导管的使用有关,其对氟康唑、两性霉素B、伏立康唑的敏感性均较高。     

1312株酵母菌的鉴定及其药敏分析

目的 分析临床标本中酵母菌的菌种分布及其对5种常用抗真菌药物的敏感性,帮助临床合理使用抗真菌药物. 方法 采用显色培养基和VITEK 32的YST鉴定卡对2009-2010年海口市人民医院临床送检的标本进行分离鉴定,并用ATB FUNGUS 3进行体外药物敏感性检测及耐药分析. 结果 1312株酵母菌中,其中白色念珠菌最多为825株(62.9％),其次为热带念珠菌206株(15.7％)和光滑念珠菌198株(15.1％).体外药敏检测结果显示氟康唑、伏立康唑对白色念珠菌、近平滑念珠菌、热带念珠菌的敏感率达90％以上;伊曲康唑对白色念珠菌和近平滑念珠菌敏感率大于80％;两性霉素B对各念珠菌的敏感率都大于95％. 结论 1312株酵母菌中白色念珠菌的比例最高,其次为热带念珠菌和光滑念珠菌.体外药敏检测结果显示氟康唑、伏立康唑和两性霉素B的敏感率较好.     

758株条件致病性真菌的临床分布及耐药性分析

摘要:目的　研究本院临床条件致病性真菌感染的分布特点、实验室诊断及耐药性情况,为临床诊断真菌感染及合理使用药物提供依据。方法　对2013年1月-2014年1月间各病区送检标本中鉴定出的758株条件致病性真菌的分类、药敏和（1,3）-β-D葡聚糖检测（G试验）情况进行回顾性分析。结果　分离出的条件致病性真菌主要来自病人的痰液标本、血液标本、体液及脓液等,其中白色假丝酵母菌562株（74.14%）,近平滑假丝酵母菌88株（11.61%）,光滑假丝酵母菌49株（6.46%）,热带假丝酵母菌38株（5.01%）,新型隐球菌13株（1.72%）和其他假丝酵母菌8株（1.06%）。白色假丝酵母菌、近平滑假丝酵母菌、皱褶假丝酵母菌和新型隐球菌对氟胞嘧啶、两性霉素B、氟康唑及伏立康唑耐药率较低（＜10%）,对伊曲康唑耐药率较高（＞10%）;光滑假丝酵母菌、热带假丝酵母菌和克柔假丝酵母菌对氟康唑、伏立康唑及伊曲康唑耐药率较高（＞10%）。对164例高度疑似系统性真菌感染或真菌菌血症患者同时进行真菌培养和G试验,阳性率分别为60.37%和76.83%。结论 假丝酵母菌感染主要以呼吸道、消化道和泌尿道感染为主,不同类型的假丝酵母菌对药物的敏感性有所不同,因此快速而准确地鉴定及药敏试验对临床及时诊断和治疗假丝酵母菌感染有着重要的意义。     

江西南昌市52株假丝酵母菌血症病原真菌的鉴定及其药敏特征

目的了解江西南昌市假丝酵母菌血症病原真菌构成及其药物敏感性。方法收集2015年3—10月南昌某医院住院患者送检血标本分离的假丝酵母菌属真菌,扩增真菌的转录间隔间区(ITS区)和核糖体大亚基(26rRNA、D1/D2区)对菌株进行鉴定,同时检测菌株对抗真菌药物的敏感性。结果共收集血培养阳性标本1 332份,真菌阳性标本74份,占5.56%,其中检出假丝酵母菌属52株,以热带假丝酵母菌为最常见(17株,占32.69%),其次是白假丝酵母菌和近平滑假丝酵母菌复合体(均为16株,各占30.77%)。ITS区和D1/D2区的鉴定结果相同。52株假丝酵母菌对米卡芬净、卡泊芬净均敏感,两性霉素B的流行病学折点(ECV)结果显示,均为野生型。热带假丝酵母菌对氟康唑和伏立康唑的耐药率分别为29.41%、17.64%,伊曲康唑和泊沙康唑的ECV结果显示,野生型分别占82.35%、94.12%;白假丝酵母菌对氟康唑和伏立康唑的敏感率分别为93.75%、81.25%,伊曲康唑和泊沙康唑的ECV显示,野生型分别占75.00%、81.25%;近平滑假丝酵母菌复合体对氟康唑和伏立康唑均敏感,伊曲康唑和泊沙康唑的ECV结果显示,均为野生型;光滑假丝酵母菌对氟康唑均为中介,伏立康唑、伊曲康唑和泊沙康唑的ECV结果显示,野生型分别占66.67%、100.00%、100.00%。结论热带假丝酵母菌为江西南昌市假丝酵母菌血症最常见的病原真菌,其次是白假丝酵母菌和近平滑假丝酵母菌复合体,唑类和棘白菌素类抗真菌药物和两性霉素B仍是一线抗真菌药物。     

假丝酵母菌性阴道炎病原菌分布及耐药性分析

目的分析假丝酵母菌性阴道炎的发病情况及耐药性。方法选取假丝酵母菌性阴道炎患者535例,取阴道分泌物进行接种培养,并进行药敏试验。结果 535例假丝酵母菌性阴道炎患者共感染6种真菌,其中白色假丝酵母菌324株,占60.56%,热带假丝酵母菌108株,占20.19%,啤酒假丝酵母菌42株,占7.85%,克柔假丝酵母菌36株,占6.73%;另有光滑假丝酵母菌18株及近平滑假丝酵母菌7株;535株假丝酵母菌属对制霉菌素、两性霉素B以及伊曲康唑耐药性较高,分别为95.51%、94.39%以及81.87%。结论调查假丝酵母菌性阴道炎患者的发病情况,分析感染菌株及其耐药性,对指导临床合理用药、减少耐药菌株产生、取得良好治疗效果有积极意义。     

Characteristics of candidaemia with Candida-albicans compared with non-albicans Candida species and predictors of mortality

Candidaemia due to non-albicans Candida species is increasing in frequency. We describe 272 episodes of candidaemia, define parameters associated with Candida albicans and other Candida species, and analyse predictors associated with mortality. Patients with C. albicans (55%) had the highest fatality rate and frequently received immunosuppressive therapy, while patients with Candida parapsilosis (16%) had the lowest fatality and complication rates. Candida tropicalis (16%) was associated with youth, severe neutropenia, acute leukaemia or bone marrow transplantation, Candida glabrata (10%) was associated with old age and chronic disease, and Candida krusei (2%) was associated with prior fluconazole therapy. The overall fatality rate was 36%, and predictors of death by multi-variate analysis were shock, impaired performance status, low serum albumin and congestive heart failure. Isolation of non-albicans Candida species, prior surgery and catheter removal were protective factors. When shock was excluded from analysis, antifungal therapy was shown to be protective. Unlike previous concerns, infection with Candida species other than C. albicans has not been shown to result in an increased fatality rate.     

念珠菌血症的菌种分布与诊疗进展

临床上念珠菌血症发生率在不断升高,为临床治疗带来了严峻挑战.致病菌种以白念珠菌为主,同时近平滑念珠菌、热带念珠菌、光滑念珠菌等非白念珠菌的感染比率逐步上升.除血培养外,其他诊断方法如β-D-葡聚糖检测试验、PCR、抗原抗体反应等新诊断方法为初始的经验性治疗提供了帮助.针对菌种变化及耐药性问题,念珠菌血症首选棘白菌素类药物治疗,同时应关注抗真菌药物不规范应用的问题.     

Susceptibilities of Candida species to amphotericin B and fluconazole: the emergence of fluconazole resistance in Candida tropicalis.

OBJECTIVE: To determine the susceptibilities of Candida species isolated from Taiwan to amphotericin B and fluconazole. DESIGN: Prospective surveillance study. METHODS: Each hospital was asked to submit up to 10 C. albicans and 40 non-albicans Candida species during the collection period, from April 15 to June 15, 1999. One isolate was accepted from each episode of infection. The broth microdilution method was used to determine susceptibilities to amphotericin B and fluconazole. RESULTS: Only 3 of 632 isolates, one each of C. famata, C. krusei, and C. tropicalis, were resistant to amphotericin B. A total of 53 (8.4%) of 632 clinical yeast isolates, consisting of 4% C. albicans, 8% C. glabrata, 15% C. tropicalis, and 70% C. krusei, were resistant to fluconazole. In contrast, no C. parapsilosis isolate was resistant to fluconazole. Isolates from tertiary-care medical centers had higher rates of resistance to fluconazole than did those from regional and local hospitals (11.4% vs 6.6%). Isolates from different sources showed different levels of susceptibility to fluconazole. All of the isolates with the exception of C. tropicalis and C. krusei isolated from blood were susceptible to fluconazole. A pattern of co-resistance to both amphotericin B and fluconazole was observed. CONCLUSIONS: Non-albicans Candida species had higher rates of resistance to fluconazole than did C. albicans (44 of 395 [11.2%] vs 9 of 237 [3.8%]; P = .002). The increasing rate of fluconazole resistance in C. tropicalis (15%) is important because C. tropicalis is one of the most commonly isolated non-albicans Candida species.     

酵母菌引起深部感染的病原学特征

目的：了解近年来深部酵菌感染的病原学特征。方法：鉴定酵母菌的常规在CHROMagar念珠菌显色培养基，玉米－吐温80培养基及血清的接种，通过菌落，显色特征，芽管试验，厚膜孢子，假菌丝等形态学观察以及商品试剂盒包括API20C AUX和VITEK YBC生化卡鉴定菌种，血培养使用VITAL血培养检测仪。结果：1998年5月－2002年5月4年间从深部标本中共分离出酵母菌307株，其中念珠菌占94．79％，检出率前4位的菌种分别为：白色念珠菌（47．88％）、热带念珠菌（26．72％），光滑念珠菌（8．47％）、近平滑念珠菌（7．49％）。结论：白色念珠菌所占比例虽最高，但不同标本中各菌种所占比例有所不同。     

深部真菌的临床分布与耐药分析

目的分析掌握本院临床分离出的深部真菌菌群分布及耐药情况,为临床合理应用抗念珠菌药物提供依据。 方法回顾性分析青岛市第三人民医院2012至2014年9 875例门诊和住院的感染患者各种临床标本中,经常规培养分离出真菌后,用VITEK-2全自动微生物分析仪鉴定到种;用丹麦Rosco抗真菌药敏纸片扩散法进行药敏试验,以确定其耐药性。 结果从9 875份标本中分离出6种237株深部真菌,各类标本的真菌培养阳性率为2.4% (237/9 875份);以白色假丝念珠菌和热带假丝念珠菌为主,分别占70.9%(168/237株)、19.8%(47/237株);其余为近平滑假丝念珠菌[2.1%(5/237株)]、葡萄牙假丝念珠菌[1.3%(3/237株)]、光滑假丝念珠菌[2.5%(6/237株)]、曲霉[3.4%(8/237株)];2012至2014年深部真菌培养检出阳性率分别为1.9%(54/2 798株)、2.4%(76/3 127株)、2.7%(107/3 950株),分别占阳性标本的6.9%(54/781株)、8.1%(76/933株)、8.6%(107/1 248株),真菌培养检出阳性率有逐年上升趋势。其中白色假丝念珠菌和热带假丝念珠菌对氟康唑、伊曲康唑、酮康唑耐药率较高,分别为16.1%(27/168株)、14.3%(24/168株)、14.9%(25/168株)和12.8%(6/47株)、19.1%(9/47株)、17.0%(8/47株)。 结论临床深部真菌的检出率有逐年上升趋势,以白色假丝念珠菌和热带假丝念珠菌为主,二者对氟康唑、伊曲康唑、酮康唑均具有较高的耐药率,应引起临床关注。     

Non-albicans Candida spp. causing fungaemia: pathogenicity and antifungal resistance

Non-albicans Candida (NAC) species cause 35-65% of all candidaemias in the general patient population. They occur more frequently in cancer patients, mainly in those with haematological malignancies and bone marrow transplant (BMT) recipients (40-70%), but are less common among intensive care unit (ITU) and surgical patients (35-55%), children (1-35%) or HIV-positive patients (0-33%). The proportion of NAC species among Candida species is increasing: over the two decades to 1990, NAC represented 10-40% of all candidaemias. In contrast, in 1991-1998, they represented 35-65% of all candidaemias. The most common NAC species are C. parapsilosis (20-40% of all Candida species), C. tropicalis (10-30%), C. krusei (10-35%) and C. glabrata (5-40%). Although these four are the most common, at least two other species are emerging: C. lusitaniae causing 2-8% of infections, and C. guilliermondii causing 1-5%. Other NAC species, such as C. rugosa, C. kefyr, C. stellatoidea, C. norvegensis and C. famata are rare, accounting for less than 1% of fungaemias in man. In terms of virulence and pathogenicity, some NAC species appear to be of lower virulence in animal models, yet behave with equal or greater virulence in man, when comparison is made with C. albicans. Mortality due to NAC species is similar to C. albicans, ranging from 15% to 35%. However, there are differences in both overall and attributable mortality among species: the lowest mortality is associated with C. parapsilosis, the highest with C. tropicalis and C. glabrata (40-70%). Other NAC species including C. krusei are associated with similar overall mortality to C. albicans (20-40%). Mortality in NAC species appears to be highest in ITU and surgical patients, and somewhat lower in cancer patients, children and HIV-positive patients. There is no difference between overall and attributable mortality, with the exception of C. glabrata which tends to infect immunocompromised individuals. While the crude mortality is low, attributable mortality (fungaemia-associated mortality) is higher than with C. albicans. There are several specific risk factors for particular NAC species: C. parapsilosis is related to foreign body insertion, neonates and hyperalimentation; C. krusei to azole prophylaxis and along with C. tropicalis to neutropenia and BMT; C. glabrata to azole prophylaxis, surgery and urinary or vascular catheters; C. lusitaniae and C. guilliermondii to previous polyene (amphotericin B or nystatin) use; and C. rugosa to burns. Antifungal susceptibility varies significantly in contrast to C. albicans: some NAC species are inherently or secondarily resistant to fluconazole; for example, 75% of C. krusei isolates, 35% of C. glabrata, 10-25% of C. tropicalis and C. lusitaniae. Amphotericin B resistance is also seen in a small proportion: 5-20% of C. lusitaniae and C. rugosa, 10-15% of C. krusei and 5-10% of C. guilliermondii. Other NAC species are akin to C. albicans-susceptible to both azoles and polyenes (C. parapsilosis, the majority of C. guilliermondii strains and C. tropicalis). Therefore, 'species directed' therapy should be administered for fungaemia according to the species identified-amphotericin B for C. krusei and C. glabrata, fluconazole for other species, including polyene-resistant or tolerant Candida species (C. lusitaniae, C. guilliermondii). In vitro susceptibility testing should be performed for most species of NAC in addition to removal of any foreign body to optimize management.     

Candida species bloodstream infection: epidemiology and outcome in a single institution from 1991 to 2008

Candidaemia remains a major cause of morbidity and mortality in the healthcare setting. Candida spp. bloodstream infection episodes prospectively recorded through a blood culture surveillance programme in a single institution from 1991 to 2008 were included in the study. Data regarding candidaemia episodes were analysed, including specific fungal species and patient survival at 30 days after diagnosis. There were 529 candidaemia episodes during the study period (495 were nosocomial infections). The incidence of candidaemia caused by non-Candida albicans Candida spp. (52%) was higher than the incidence of candidaemia caused by C. albicans (48%). The overall crude 30 day mortality rate was 32%. Patients with Candida parapsilosis candidaemia had the lowest mortality rate (23%). Candida krusei candidaemia was most commonly associated with haematological malignancy (61%; P < 0.001), stem cell transplantation (22%; P = 0.004), neutropenia (57%; P = 0.001) and prior use of antifungal azole agents (26%; P < 0.001). Patients with C. krusei candidaemia had the highest crude 30 day mortality in this series (39%). Epidemiological studies are important to define clinical and microbiological candidaemia characteristics and to guide empirical treatment in every setting.     

Anti-Candida activity of Mentha arvensis and Turnera ulmifolia

Candidiasis is the most frequent infection by opportunistic fungi, frequently caused by Candida albicans, Candida tropicalis, Candida parapsilosis, Candida glabrata, and Candida krusei. Mentha arvensis L. is a herbaceous plant that occurs throughout South America and is used as a tea and in the folk medicine. Turnera ulmifolia L. is already known to be of medicinal value. Ethanol extracts from M. arvensis and T. ulmifolia were assayed for antifungal activity against strains of C. albicans, C. tropicalis, and C. krusei. No clinically relevant antifungal activity was demonstrated by the extracts; however, a potentiation effect was observed when the extracts were applied with metronidazole against C. tropicalis. M. arvensis and T. ulmifolia could represent a source of natural products with modifying antifungal activity.     

院内侵袭性深部真菌感染80例临床与病原学分析

目的探讨深部真菌感染的现状、病原菌的种类、常用抗真菌药物的敏感性及防治策略。方法回顾性地分析2004年1月-2005年12月，真菌感染患者的临床状况，并对收集的病原菌进行体外药敏测定。结果2年中共收集88株真菌培养阳性的临床标本，其中确诊或疑诊为假丝酵母菌属感染者72例，占81．8％，其次为新型隐球酵母菌8例，占9．1％，曲霉菌属5例，占5．7％，其余为其他真菌；其中假丝酵母菌属中最常见的病原菌为白色假丝酵母菌，共48株，占66．7％，其次为光滑假丝酵母菌12株，占16．7％，再次为热带假丝酵母菌8株，占11．1％，最后为近平滑假丝酵母菌和克柔假丝酵母菌各2株，分别占2．8％。结论假丝酵母菌属仍然是院内深部真菌感染的主要致病菌，而假丝酵母菌属中最常见的是白色假丝酵母菌感染，氟康唑仍是治疗假丝酵母菌属尤其是白色假丝酵母菌感染最有效的药物。     

呼吸道标本分离的假丝酵母菌分布及耐药性

目的调查近年住院患者呼吸道标本分离的假丝酵母菌属菌种分布及耐药性变化趋势，为临床合理使用抗真菌药物提供依据。方法对青岛中心医疗集团所属各医院2007-2011年38 326例住院患者送检的呼吸道标本，采用沙保罗培养法培养；VITEX32全自动细菌培养系统YBC鉴定卡或FUNGS CA20进行酵母菌鉴定；ATB FUNGUS 3真菌药敏试验板进行药敏试验。应用WHONET5.4软件对药敏结果进行分析。结果38 326份送检标本共分离假丝酵母菌属2 745株（7.16%），其中白假丝酵母菌2 036株(74.17%)，热带假丝酵母菌348株(12.68%)，光滑球拟酵母菌118株(4.30%)，副秃发酵母菌57株（2.08%)，克柔假丝酵母菌57株（2.08%)，其他假丝酵母菌129株（4.70%）。假丝酵母菌属对常用抗真菌药物的耐药率从高至低依次为伊曲康唑、氟康唑、伏立康唑、氟胞嘧啶、两性霉素B。经χ2检验，所有假丝酵母菌对氟胞嘧啶、两性霉素B、氟康唑的耐药率，2007-2011年无变化（两两比较，P＞0.05）；对伊曲康唑、伏立康唑的耐药率，2007-2011年有所上升（两两比较，P＜0.05）。结论呼吸道感染的假丝酵母菌属以白假丝酵母菌为主；对抗真菌药物已出现不同程度的耐药，并呈增加趋势。     

重症监护室患者体外插管假丝酵母菌属鉴定及耐药性分析

了解某医院重症监护室（ICU）患者实施体外插管中真菌感染及其耐药情况。方法采集该院ICU84例患者的各种插管标本161份,将其接种于假丝酵母菌显色培养基,API 20C AUX鉴定试剂盒作菌株鉴定,ATB FUN 3药敏测试试剂盒进行药敏试验。结果161份标本中检出真菌98株（60.87％）,以白假丝酵母菌（52株,53.06％)为主,其余依次为热带假丝酵母菌（14株,14.29％）、光滑假丝酵母菌（11株,11.22％）、近平滑假丝酵母菌（9株,9.18％）和克柔假丝酵母菌（12株,12.25％)。其中呼吸道插管分离60株（61.22％）,留置导尿管25株（25.51％）,静脉插管13株（13.27%）。分离菌株对5 氟胞嘧啶、两性霉素B和伏立康唑的耐药率均＜10％,对伊曲康唑的耐药率为12.24%;而光滑假丝酵母菌、近平滑假丝酵母菌和克柔假丝酵母菌对氟康唑的耐药率均＞45％。结论ICU患者各种插管中真菌感染以白假丝酵母菌为主;呼吸道插管感染率最高;各类假丝酵母菌对5 氟胞嘧啶、两性霉素B和伏立康唑耐药性较低,而对氟康唑耐药性较高。