泌尿系统真菌感染的分布及其耐药性分析

目的：了解临床泌尿系统真菌分布及其药敏情况，指导临床合理使用抗菌药物。方法对2012年1月至2013年6月期间临床送检的泌尿系统标本进行真菌鉴定，并检测其对5种抗菌药物的敏感性，结果采用 WHONET 软件进行统计学分析。结果（1）共分离出真菌239株，其中白色念珠菌居首位，其余依次为光滑念珠菌和热带念珠菌；（2）239株真菌对氟康唑（FCA）、伊曲康唑（ITR）、伏立康唑（VRC）、5-氟胞嘧啶（5-FC）及两性霉素（AMB）的敏感率分别为63．2％、61．9％、92．5％、93．7％及93．7％；（3）白色念珠菌对5种抗菌药物的敏感性较好，均达到95．0％以上；（4）光滑念珠菌对 FCA 和 ITR 的敏感性最低，仅为9．7％。结论泌尿系统真菌感染以白色念珠菌为主，由于各种念珠菌对5种抗真菌药物的敏感性不同，因此加强泌尿系统真菌鉴定及药敏检测，能够为临床合理使用抗菌药物提供重要参考依据。

Distribution and drug resistance of fungi isolated from urinary tract infection

Objective To understand the distribution and drug resistance of fungus isolated from urinary tract infection for guid-ing clinical rational drug use.Methods The clinically submitted urinary system samples from January 2012 to June 2013 were per-formed the fungal identification and the drug susceptibility test to 5 kinds of anti-fungal drugs.The detection results were analyzed by the WHONET software.Results （1）239 strains of fungi were isolated,in which Candida albicans occupied the top place,fol-lowed by Candida glabrata and Candida tropicalis;（2）the sensitivity rates of 239 fungal strains to fluconazole（FCA）,itraconazole （ITR）,voriconazole（VRC）,5-fluorocytosine（5-FC）and amphotericin B（AMB）were 63.2%,61.9%,92.5%,93.7% and 93.7%respectively;（3）Candida albicans had the high sensitivity to 5 kinds of anti-fungal drugs,which reached more than 95%;（4）Candida gla-brata had the lowest sensitivity to FCA and ITR,only 9.7%.Conclusion The fungal infection in the urinary system is dominated by Candi-da albicans,due to the different sensitivity to 5 kinds of anti-fungal drugs in different fungi,therefore strengthening the fungal identification of the urinary system and the drug sensitivity test can provide the important reference basis for clinical rational use of anti-fungal drugs.