肝移植术后真菌感染的防治新策略

目的探讨肝移植术后病人真菌感染的菌群变化特点和相应的防治策略。方法回顾性分析中山大学附属第三医院肝移植中心2004—2005年485例原位肝移植病人术后真菌感染的流行病学资料和药敏结果。结果485例病人中79例出现术后真菌感染，真菌感染率为16．3％，共分离出菌株88株，其中念珠菌71株（白色念珠菌35株，非白色念珠菌36株），曲霉菌17株，在菌群分布上2004年和2005年差异有显著性（P〈0．05）。念珠菌对氟康唑的耐药率2005年（60．0％）较2004年（33．3％）明显上升（P〈0．05）。结论肝移植术后非白色念珠菌和曲霉菌感染的比例逐渐上升，临床上应根据分离培养结果选择适当的抗真菌药物。

New strategy of prevention and treatment for fungal infection after liver transplantation

Objective To investigate the distribution of fungal infection and the corresponding prevention and treatment after liver transplantation.Methods Epidemiology data and susceptibility test of 485 cases of orthotropic liver transplantation were retrospective analyzed between 2004 and 2005.Results 88 fungi strains were isolated in 79 patients and the infection rate was 16.3%.Among them 71 strains were albicans in which 35 strains Candida albicans and 36 strains other Candida albicans,17 strains were aspergillus.There was significant difference in the distribution of fungi between 2004 and 2005( P <0.05).The resistence of albicans to fluconazole in 2005 (60%) was significantly higher than that in 2004 (33.3%)( P <0.05).Conclusion The percentage of other Candida albicans and aspergillys is increasing.We should select appropriate anti-fungal drug according to the cultivation.