肝移植患者真菌感染的流行病学特点及耐药性分析

目的了解肝移植术后真菌感染的种类及耐药特性,为临床治疗提供依据。方法分析2003年6月至2006年6月,我院67例肝移植患者术后感染的标本,鉴定真菌种类,分析其耐药性。结果67例肝移植患者有21例发生真菌感染,占肝移植患者的31.3%;共检出73株真菌,以酵母菌感染为主,占98.6%,其中近平滑念珠菌、白色念珠菌、热带念珠菌、季也蒙念珠菌、克柔念珠菌的检出率分别是53.4%、21.9%、9.6%、8.2%、2.7%。曲霉菌感染1例。药敏试验显示73株真菌对两性霉素B(AMB)、5-氟胞嘧啶(5-FC)、制霉菌素(MYS)、酮康唑(KTC)、益康唑(ECO)和咪康唑(MIC)的平均敏感率分别为98.6%、95.7%、87.1%、70.0%、65.7%和64.3%。结论加强肝移植术后真菌的鉴定和耐药性监测,对指导临床治疗具有重要意义。

Epidemiology of fungal infection and drug resistance in liver transplantation patients

Objective To investigate the epidemiology of fungal infection and the drug resistance after liver transplantation,and to provide guidance for the therapy.Methods Identified the fungi which had been isolated from 67 liver transplantation patients since 2003,and analyzed the drug resistance.Results Among 67 patients,21 patients had fungal infection,and 73 clinical isolates collected from them,microzyme accounted for 98.6%,Candida parapsilosis,Candida albicans,Candida tropicalis,Candida gualliermondii,Candida krusei were the most common epiphyte,the proportion was 53.4%,21.9%,9.6%,8.2% and 2.7%,respectively.The resistance rate to AMB,5-FC,MYS,KTC,ECO and MIC were 98.6%,95.7%,87.1%,70.0%,65.7%,64.3%,respectively.Conclusions It is necessary to strengthen identification and resistance monitoring of fungi after liver transplantation.Useing antibiotics appropriately can decrease the infection efficiently.