599株念珠菌感染的菌群分布及耐药性分析

目的 了解临床念珠菌感染类型、分布及其对常用抗真菌药物的敏感性,为临床诊断治疗提供可靠的用药依据.方法 采用常规方法 分离培养真菌,对新疆医科大学第五附属医院2010年1月-2011年12月培养出的599株念珠菌用科玛嘉念珠菌显色培养基进行鉴定,并用微生物药敏进行真菌药敏分析.结果 (1) 599株念珠菌标本来源构成比,念珠菌的检出率以痰液为主(89.8%),其次为尿液(4.5%),念珠菌的检出率在血液中最少(0.7%).(2) 599株念珠菌中,以白色念珠菌检出最多,为372株(62.1%),其次为热带念珠菌61株(10.2%)、光滑念珠菌59株(9.8%)、克柔念珠菌21株(3.5%)、近平滑念珠菌16株(2.7%)、其他念珠菌70株(11.7%).(3)药敏试验结果 表明念珠菌对5-氟胞嘧啶(5-FC)、伏力康唑(VRC)的敏感率较高;对氟康唑(FCA)、伊曲康唑(ITR)有不同程度的耐药.结论 念珠菌在医院内感染呈上升趋势.药敏监测非常必要,临床医生应根据药敏结果 合理使用抗真菌药物,有效预防真菌感染和耐药性发生.

Distribution and drug resistance of 599 strains of Candida infection

Objective To understand the clinical Candida infection types,distribution and the susceptibility to common antifungal agents,to provide reliable basis for clinical diagnose and treatment.Methods The fungi was isolated and cultureed by using the conventional methods.From January 2010 to December 2011,in the Fifth Affiliated Hospital of Xinjiang Medical University,599 strains of Candida albicans were evaluated with CHRO Magar Candida chromogenic medium for identification,microbial susceptibility was used to analyze antifungal drug susceptibility.Results(1) In 599 strains of Candida from constituent ratio,the positive rate of Candida mainly in sputum,which accounted for(89.8),next was urine(4.5%),the positive rate of Candida in the blood was at the least(0.7%).The yeast-like fungal disease species appeared diversification.(2) In 599 strains of Candida,a maximum of 372 cases were detected Candida albicans infection(62.1%),followed by Candida tropicalis(10.2%),59 cases(9.8%) of Candida glabrata,21 cases(3.5%) of Candida krusei Candida parapsilosis,16 cases(2.7%),the other Candida species in 70 cases(11.7%).(3) The results of drug sensitive test indicated that Candida was sensitive to 5-flucytosine,voltconazole,and had varying degrees of resistance on fluconazole and itraconazole.Conclusion Candida infections in hospitals is on the rise.Susceptibility monitoring is necessary,the clinician should use antifungal drugs,based on the results of drug sensitive test,in order to prevent fungal infection and drug resistance effectively.