临床标本中酵母菌的耐药性分析

目的 了解临床标本中酵母真菌的分布及对常见抗真菌药物的耐药性。方法 应用常规方法进行酵母真菌的分离和鉴定，采用微量MIC法进行酵母真菌的药敏试验。结果 白色念珠菌占40．6％，热带念珠菌占40．3％，克柔念珠菌占9．6％，其它非白色念珠菌占9．6％；念珠菌对两性霉素B、酮康唑，咪康唑、伊曲康唑、氟康唑，5—氟胞嘧啶、特比奈芬的总耐药率分别为35％、58％、74％、86％、74％、9％、85％，白色念珠菌对上述7种药物的耐药率分别达到52％、64％、68％、86％、36％、8％、98％，热带念珠菌别分613为22％、65％、82％、90％、65％、5％、82％，克柔念珠菌分613为0％、0％、70％、70％、30％、30％、30％。结论 酵母真菌的临床标本中约分布已发生变化，白色念珠菌比例下降，非白色念珠菌比例增加；酵母真菌对常用的抗真菌药物的耐药率除5—氟胞嘧啶、两性霉素B外均较高，临床经验用药应依据药敏结果合理选用。

Study on the susceptibility of common antifungal drugs and their distribution of yeast-like fungi in clinical samples

Objective To study the distribution of yeast like fungi in clinical samples and their susceptibility to several common antifungal drugs.Methods Yeast like fungi were isolated and identified by routine methods.Susceptibility were tested with micro MIC methods.Results In portion to total,C.albicans were 40.6%,C.tropicalis were 40.3%,C.Krusei were 9.3% and other species were 9.6%.The total resistance to Amphotericin B,Ketoconazol,Miconazole,Itraconazole,Fluconazole,5 Fluorocytosine,Terbinafine of candida were 35%,58%,74%,86%,74%,9%,85%,respectively.Of C.albicans,the resistances to the seven kinds of drugs above mentioned reached 52%,64%,68%,86%,36%,8%,98% respectively.Of C.tropicalis were 22%,65%,82%,90%,65%,5%,82% respectively.Of C.krusei were 0%,0%,70%,70%,30%,30%,30% respectively.Conclusion The distribution of yeast like fungi in clinical samples had changed C.albicans decreased in portion while non albicans increased except to 5 Fluorocytosine,Amphotericin B,yeast like fungi had high resistances to most common antifungal drugs,so in experiential therapy,drugs should be selected according to susceptibility tests.