临床酵母样真菌的感染特点及耐药性研究

目的了解临床酵母样真菌的感染类型、分布以及耐药情况,为临床诊断治疗提供合理的用药依据.方法采用常规方法进行真菌培养,用科玛嘉显色培养基联合法国生物梅里埃API 20C AUX鉴定条进行鉴定,药敏试验采用微量稀释法.结果864株酵母样真菌中,白色念珠菌619株（71.6%）,其次为热带念珠菌116株（13.4%）和克柔念珠菌47株（5.4%）,非白色念珠菌感染的比例逐年上升（21.5%）.其中,呼吸道标本酵母样真菌检出率最高,达79.7%,其次是消化道为8.8%,泌尿道为4.7%.科室分布依次为干部科、呼吸科、急诊内科、血液科等;白色念珠菌对两性霉素B、5-氟胞嘧啶高度敏感,达90%以上,对氟康唑和伊曲康唑的敏感性有所降低.结论酵母样真菌的检出率与患者基础疾病密切相关;对氟康唑等药物的敏感性有下降的趋势,未发现对4种药物同时耐药的菌株,提示在治疗中,药敏监测是非常必要的.

Research of the characteristics of yeast-like fungi infection and drug resistance

Objective To realize the type and distribution of fungi infection and drug resistance which will guide the diagnosis and therapy for clinical doctors.Methods A total of 864 strains of yeast-like fungi were identified with CHRO-Magar medium and API-20C AUX strips.Drug susceptibilities test of Candida was tested by microdilution method.Results Among 864 strains,Candida albicans accounted for 619 strains(71.6%),C.tropicalis 116 strains(13.4%),C.krusei 47 strains(5.4%),the rate of non-Candida abicans infection presented a higher trend year by year(21.5%).The infection rate of yeast-like fungi from respiratory tract was the highest, accounted for 79.7%,digestive tract and urinary come second.The distribution of Dept.were Senioior cadres medicial,Dept.of respiratory medicine,Dept.of emeryency medicine,Dept of hematology etc.The Candida albicans showed strong sensitivity to Amphotericine B and 5-Flucytosine,but to Fluconazole and Itraconazole were more weak than before.Conclusions The detectable rate of yeast-like fungi were intently related to the type of basic diseases;Susceptibilities to Fluconazole decreased,we did not detect any strain was resistnat to all four drugs synchronously.So we suggest that it was necessary to monitor antifungal susceptibility in treatment.