肿瘤患者医院内侵袭性酵母菌感染的研究

摘要

Objective To investigate the clinical distribution and drug-susceptibility characteristics of yeast speeies in tumor patients with invasive yeast infections in order to provide the gist for clinical therapy.Methods The medical records of 70 tumor patients with invasive yeast infections from January 2006 to December 2008 were collected.retrospectively.The relationship between different tumor types and invasive yeast infections was analyzed.The clinical distribution and drug-susceptibility characteristics of 70 isolates of yeast were investigated.Results The sites of invasive yeast infections were abdominal(32 cases),blood(18 cases),biliary(9 cases),central nervous system(6 cases)and chest infection(5 cases).respectively.The most common species causing the above infections was Candida albicans(34 isolates,48.6%).The mortality of invasive yeast infection was 15.7%.The main types of tumor in 70 patients with invasive yeast infections were pancreatic carcinoma(12 cases),stomach carcinoma(11 cases)and hepatocellular carcinoma(7 cases).No relationship was found between tumor types and yeast infections with different species(P=0.804,P>0.05).There were 18 patients with tumor metastasis.Among them.9 patients had yeast bloodstream infections and 6 with yeast abdominal infections.Yeast bloodstream infections were more likely to be found in patients with tumor metastasis(χ~2=5.357,P<0.05).Seventy isolates of yeasts were all sensitive to triazoles.The MIC values of amphotericin B aginst 6 isolates of Candida and 2 Laurent cryptococcal were 2μg/ml.Conclusion Patients with tumor metastasis should be paid more attention for yeast invasive infections.and triazoles kept activity against yeasts tested.%目的 分析并探讨肿瘤患者侵袭性酵母菌感染与肿瘤的关系、菌株分布及药敏情况,为临床预防及治疗酵母菌感染提供理论依据.方法 采用回顾性分析的方法,搜集2006年1月至2008年12月70例深部酵母菌感染的肿瘤患者的病历资料,分析肿瘤与酵母菌感染之间的关系,以及所检出的70株酵母菌的分布及药敏情况.结果 酵母菌感染的部位分别为腹腔(32例)、血液(18例)、胆系(9例)、神经系统(6例)及胸腔(5例),各部位主要感染菌株均为白色念珠菌(34株,占48.6%),酵母菌感染的相关病死率为15.7%.70例发生酵母菌感染的患者主要肿瘤类型为胰腺癌(12例)、胃癌(11例)及肝癌(7例),主要感染菌株为白色念珠菌(48.6%).肿瘤类型与不同念珠菌感染之间没有相关性(P=0.804,P>0.05).18例肿瘤远处脏器转移的患者中发生酵母菌性血流感染者9例、腹腔酵母菌感染者6例肿瘤转移患者更易发生酵母菌性血流感染(χ~2=5.357,P<0.05).70株酵母菌对三唑类均敏感,但其中6株念珠菌及2株罗伦特隐球菌对两性霉素B的MIC值为2μg/ml.结论 应警惕肿瘤转移患者发生酵母菌感染,三唑类药物对酵母菌保持较高的抗菌活性.