临床深部真菌感染的菌群分布与耐药性分析

目的了解我院深部真菌感染的菌群分布与耐药特点,为临床合理使用抗真菌药物提供依据。方法采集2007.1-2007.12门诊和住院病人的各种标本,采用科玛嘉显色培养基和API20CAUX进行鉴定,ROSCO纸片扩散法进行药敏实验。结果检出深部真菌106株,居前3位为白色念珠菌61株(57.5%)、热带念珠菌17株(16.0%)、光滑念珠菌8株(10.4%);标本检出率前3位为痰液63.2%、尿液13.2%、大便8.5%;科室来源主要是ICU、干部病房、肿瘤科。各种真菌对两性霉素B、氟康唑、酮康唑、伊曲康唑四种抗真菌药物出现不同程度的耐药,其中光滑念珠菌等非白色念珠菌对唑类药物耐药率较高。结论深部真菌感染主要由白色念珠菌、热带念珠菌、光滑念珠菌引起,以呼吸道、尿道和消化道感染常见。不同真菌对常用抗真菌药物敏感性不同,准确分离鉴定和药敏试验,对指导临床医生合理用药有重要意义。

Distribution and Antibiotic Resistance Analysis in Deep Fungal Infections

Objective To investigate the distribution of fungal infection and characteristics of drug resistance,to provide the evidence of suitable anti-fungul treatment.Methods To collect all kinds of samples from Jan.to Dec.2007.The fungul was identified by CHRO-Magar medium or API 20C AUX,and drug susceptibility test was conducted by ROSCO Disk Diffusion method.Results 106strains fungi were isolated.The infection of Canadida albicans predominated,61 strains accounted for 57.5%,17strains(16.0%)of C.tropicalis,8strains(10.4%)of C.glabrata were isolated.The samples were mainly sputum(63.2%),urine(13.2%),stool(8.50%).ICU,cadre ward and oncology department were mainly involved.All kinds of fungi were variably resistance to anphotericin B,fuconazole,ketoconazole and itraconazole,C.glabrataand and other non-candida alobicans have a highly resistance rate to zole medicines.Conclusion Candida albicans,C.tropicalis and C.glabrata are the main pathogens responsible for deep fungi infection,which dominated in respiratory tract,urine tract and digestive tract.Different species of fungi may show varied susceptibility to common anti-fungal agents.Therefor,accurate information on species identification and drug sensitivity should help proper antifungal treatment in clinical practices.