临床分离206株念珠菌的培养鉴定及其耐药性分析

摘要

Objective To isolate and identify 206 strains of candida,and to test their microbial sensitivity in order to guide rational clinical administration. Methods Samples including sputum, urine, blood and other secretion sent for detection from Jan. to Dec. 2010, were cultured and isolated by routine methods, and identified with France Biomerieux ATB express system. A drug sensitivity test was done by ATB fungus strip. Results Among the 206 strains of candida,Candida albicans was the most frequently species(41.75％),followed by C. tropicalis(24.76％),C, parapsilosis(14.08％),C, krusei(9.71％),C, glabrata(7.28％) and others (2.43％). All the 206 strains of candida were sensitive to amphotericin B and did not express resistance, most of them were sensirive to 5 fluorocytosine and nystatinum,and the resistance rates were lower. The resistance rates of most of them to ketoconnazole,econazole,miconazole were higher and cross resistance appeared. Conclusion Fungi are required to be sent for classification and drug resistance study so as to rationally use anti fungal agent to reduce the development of drug resistant strains.%目的 对引起感染的206株临床分离的念珠菌进行分离鉴定和药敏试验,了解念珠菌耐药现状,以指导临床合理用药.方法 收集2010年1～12月临床送检的痰液、尿液、血液及各种分泌物等标本,采用常规方法培养和分离念珠菌,用法国生物梅里埃ATB express系统对念珠菌进行鉴定,用ATB fungus药敏试条进行药敏试验.结果 206株念珠菌中,白色念珠菌占41.75%、热带念珠菌占24.76%、近平滑念珠菌占14.08%、克柔念珠菌占9.71%、光滑念珠菌占7.28%、其他念珠菌占2.43%.206株念珠菌对两性霉素B敏感,未出现抗药性;绝大多数菌株对5-氟胞嘧啶、制霉菌素敏感,耐药率较低;对3种咪唑类药物(酮康唑、益康唑、咪康唑)耐药率较高且出现交叉耐药.结论 临床需要加强真菌送检培养,合理使用抗真菌药物,尽量避免单纯经验用药,以减少耐药菌株的出现.