侵袭性真菌感染患者真菌培养及耐药性研究

摘要

Objective:To understand the nosocomial invasive fungal infection (IFI) condition and resistance in our hospital from September 2013 to January 2016.Method:861 patients with suspected IFI samples were selected for fungal culture,identification and drug sensitive test,and the related clinical data for the diagnosis of patients with invasive fungal disease(IFD) were investigated and analyzed.Result:In 107 patients with IFD,white candida was the most common, accounted for 46.73%(50/107),and the rest of aspergillus species accounted for 41.12%(44/107),candida yeast was 7.48%(8/107),smooth candida yeast was 2.80%(3/107),candida accounted for 1.87%(2/107).Drug susceptibility test results,the fungus on the total resistance to antimicrobial agents from low to high followed by Itraconazole,Fluorine Cytosine,Mycin,Amphotericin B,Ketoconazole.IFD patients were higher in ICU and respiratory medicine.Conclusion:In ICU and respiratory medicine IFD are high incidence,white candida is the highest,followed by aspergillus species.Actively cultivating fungi and drug resistance detection analysis for early intervention and rational use of antimicrobial agents has important clinical significance.%目的：了解笔者所在医院2013年9月-2016年1月院内侵袭性真菌感染(IFI)状况及耐药性。方法：对861例疑似IFI患者送检标本进行真菌培养、鉴定和药敏试验，并对确诊为侵袭性真菌病(IFD)的患者进行相关临床资料的调查、分析。结果：107例IFD患者中，白色假丝酵母菌最常见。占46.73％(50/107)，其余依次为曲霉菌属占41.12％(44/107)、热带假丝酵母菌占7.48％(8/107)、光滑假丝酵母菌占2.80％(3/107)、克柔假丝酵母菌占1.87％(2/107)。药敏试验结果，真菌对抗菌药物的总耐药率由低到高依次为：伊曲康唑、氟胞嘧啶、制霉菌素、两性霉素B、酮康唑。IFD患者分布主要见于ICU、呼吸内科。结论：在ICU病房、呼吸内科等，IFD发病率高，致病菌种以白色假丝酵母菌为最高，其次为曲霉菌属；积极开展真菌培养及耐药性检测分析，对于尽早干预和合理使用抗菌药物具有重要的临床意义。