念珠菌感染菌种的分布及耐药性分析

目的了解本地区2007～2008年念珠菌感染的菌种分布和耐药性情况,为临床抗真菌治疗提供依据。方法收集本地区两家医疗机构两年间临床分离的念珠菌1462株,采用生物梅里埃ATBID32C试条进行念珠菌菌种的分离鉴定,药敏试验采用生物梅里埃ATB-FUNGU30试条对氟康唑、伊曲康唑、伏立康唑、5-氟胞嘧啶和两性霉素B等5种抗真菌药物进行测定。结果1462株念珠菌中以白色念珠菌为主,检出682株(59.6%),其他依次为热带念珠菌278株(21.3%),光滑念珠菌135株(9.2%),近平滑念珠菌70株(4.8%),克柔念珠菌27株(1.8%),其他念珠菌46株(3.1%)。念珠菌对伊曲康唑、氟康唑、5-氟胞嘧啶、两性霉素B和伏立康唑的耐药率分别为28.9%、10.6%、3.1%、1.5%和0。结论本地区念珠菌感染以白念珠菌为主,对伊曲康唑和氟康唑耐药性较高,对5-氟胞嘧啶、两性霉素B和伏立康唑敏感性较高。本地区应建立真菌常规菌种鉴定及药敏试验,指导临床合理用药。

Candida Species Distribution and Resistance to Antifungal Agents

Objective To investigate the candida species distribution and susceptibility of Candida species to antifungal agents in Foshan city during 2007 to 2008,and provide evidence for diagnosis and treatment of fungi infection. Methods In a 2-year surveillance programme, 1462 Candida stains were collected from two local medical institutions,Candida strains were identified by bioM e rieux ATB ID32C test paper. Antifungal suseeptibihty of fluconazol,itraconazole,voriconazole,5-flurocytosine and amphotericin B was assessed by bioM 6 rieux ATB-FUNGU30 test paper method. Results Among 1462 strains examined,Candida albicans accounted mainly for 59.6%（682 strains）,and the other species accounted for 31.3% including,tropicalis 21.3%（278 strains）,Candida glabrata 9.2%（135 strains）,Candida parapsilosi 4.8%（70 strains）,Candida krusei and 1.8%（27 strains）and the other Candida 3.1%（46 strains）. The resistant rates to itraconazole,fluconazol,5-flurocytosine,amphotericin B and voriconazole were 28.9%, 10.6% ,3.1%, 1.5% and O,respectively. Conclusion The pathogens causing fungus infection are mainly C. albicans in Foshan city,and it shows more sensitive to 5-flurocytosine,amphoteficin B and voriconazole compared with itraconazole and flu- conazol. The Fungi and Fungal pathogens routine strain identification and susceptibility test in this region should be established, guiding clinical rational drug use.