医院常见酵母样真菌的耐药特点分析

目的了解酵母样真菌对常用抗真菌药物的耐药情况，便于指导临床合理用药。方法真菌培养采用常规方法，采用念珠菌显色培养基进行鉴定，药敏使用微量液体培养基稀释法。结果115株酵母样真菌中，白色假丝酵母菌49株，占42．6％；光滑假丝酵母菌16株，占13．9％；近平滑假丝酵母菌16株，占13．9％；热带假丝酵母菌12株，占10．4％；克柔假丝酵母菌11株，占9．6％；季也蒙假丝酵母菌8株，占6．9％。酵母样真菌对两性霉素B、5-氟胞嘧啶、制霉菌素、咪康唑、伊曲康唑、氟康唑和酮康唑的耐药率分别为3．5％、1．7％、13．0％、25．2％、23．5％、26．1％和22．6％。结论院内酵母样真菌感染以白色假丝酵母菌最为多见，氟康唑耐药性较其他药物高。应重视真菌的检测工作，根据分离株的耐药特点采用不同治疗方案。

Analyisis of drug resistance of hospital-acquired yeast-like fungi

Objective To investigate the current drug resistance status of hospital-acquired yeast-like fungi to commonly used antifungal agents, and to provide reference for clinical therapy. Methods A total of 115 isolates of Candida spp were cultured according to the routine method and isolated with colourable Candida culture medium. The drug susceptibility was determined by broth microdilution method. Results Among the 115 strains of yeast-like fungi, the detection number （rate） of Candida albicans accounted for 49 （42.6 % ）, Candida glabrata 16 （13.9 % ）, Candida parapsilosis 16 （13.9 % ）, Candida tropitalis 12 （10.4 % ）, Candida krusei 11 （9.6 % ）, Candida guilliermondii 8 （6.9%）. The resistant rates of Candida spp to amphotericin B, 5-flucytosine, nystatin, miconazole, itraconazole, fluconazole and ketoconazole were 3.5%, 1.7%, 13.0%, 25.2%, 23.5%, 26.1% and 22.6% respectively. Conclusion Candida albicans is the most common pathogen of hospital-acquired yeast-like fungus infection, which is more resistant to fluconazole than the other antifungal agents. Detection of fungi should be paid emphasis upon, and therapeutic regimen should be adopted according to the drug resistance characteristics of isolated strains.