呼吸道真菌感染病原菌分布及耐药性分析

摘要

目的:了解临床住院患者呼吸道真菌感染的病原菌分布情况,分析常见真菌种类及耐药特点,及时为临床提供合理用药的依据.方法:用科玛嘉念珠菌显色平板进行鉴定分型,用ATB FUNGUS3真菌药敏板条进行药敏试验,用Whonet5.0软件对数据进行分析.结果:对2007年11月-2008年10月期间的住院患者送检的2 563例呼吸道标本进行真菌培养,共有230例培养出念珠菌,阳性检出率为9.0%.其中白色念珠菌142例(61.7%),热带念珠菌36例(15.7%),克柔念珠菌26例(11.3%),光滑念珠菌26例(11.3%).念珠菌各型对5种抗真菌药物敏感率由高到低依次为:两性霉素B(100%),5-氟胞嘧啶(98.2%),伏立康唑(95.7%),氟康唑(88.7%),伊曲康唑(87.0%).结论:目前引起我院患者真菌感染的念珠菌仍以白色念珠菌为主,其次是热带念珠菌.这些念珠菌对两性霉素B、5-氟胞嘧啶、伏立康唑较敏感;对氟康唑、伊曲康唑产生了较强的耐药性.%Objective:To investigate the characteristics of respiratory tract fungal infection and analyze drug resistance pattern.Methods:The fungal isolates were identified by CHROMager medium. The susceptibility were tested by ATB FUNGUS3.The data were analyzed by Whonet 0.Results:There were 2 563 species requested fungus culture from respiratory tract from Nov.2007 to Oct. 2008. 230 fungi were cultured, the positive culture rate was 9.0%.There were 142(61.7%) C.albicans, 36(15.7%) C.tropicalis, 26(11.3%) C.krusei and 26(11.3%) C.glabrata. The susceptibility to amphotericinB,5-fluorocytosine, voniconazole, fluconazole,itraconazole were 00%,98.2%,95.7%,88.7%,87.0%,respectively.Conclusion:C.albicans accounted for the most of respiratory tract fungal infection. AmphotericinB,5-fluorocytosine and voniconazole were effective for treatment of candida infections, but the resistant percentage to fluconazole and itraconazole were rising.