肺结核患者下呼吸道假丝酵母菌的分离鉴定和耐药性分析

目的分析肺结核患者下呼吸道假丝酵母菌感染的种类和耐药情况，为临床抗真菌治疗提供参考依据。方法采集1492例确诊肺结核痰标本进行真菌培养鉴定，并对部分假丝酵母菌进行药物敏感试验，调查其感染的危险因素。结果共分离下呼吸道假丝酵母菌294株，分离率为19．70％；其中以白色假丝酵母菌的分离率最高，达14．88％。7种抗真菌药物中氟胞嘧啶、两性霉素B抗菌活性强，未发现耐药株；唑类药物中氟康唑耐药率最低，但剂量依赖敏感率较高（13．61％）。结论肺结核患者假丝酵母菌继发感染率较高，宜首选氟胞嘧啶抗真菌治疗。

Identification of Candida isolates from the lower respiratory tract of pulmonary tuberculosis patients and analysis of their antifungal resistance

Objective To analyze the types and drug - resistance of pathogenic Candida in the lower respiratory tract and to investigate risk factors of nosocomial infection of pulmonary TB patients in order to provide reference for clinical antifungal treatment. Methods A total of 1492 sputum specimens were cultured and identified, and some of the Candida isolates were tested for their drug susceptibility. Results Two hundreds and ninety - four Candida strains from the lower respiratory tract were isolated （ isolating rate was 19.70% ）, of which C. albicans accounted for 14.88%. Among the seven kinds of antifungal agents, the 5 -fluorocytosine and amphotericin B possessed the best anti -candidal activity and no resistant strain was found. Fluconazole had the lowest resistant rate but a higher SDD rate （ 13.61% ） in azoles drugs. Conclusions There is a high secondary infection rate among Candida in pulmonary TB patients. 5 - fluorocytosine is the first option in anti - candidal therapy.