ICU患者深部真菌感染的病原菌分布及耐药性分析

发布时间：2018-08-02 21:26

【摘要】：目的:掌握重症加强护理病房(ICU)患者标本分离培养真菌菌种及其药敏情况,为临床真菌感染的诊疗提供依据。方法:收集2012年1月—2014年12月吉林大学第一医院ICU患者标本分离的真菌,采用回顾性研究方法,按不同年度进行分组,分析菌种分布及常见菌种的耐药情况。菌种鉴定采用VITEK-32系统,药物敏感试验采用Fungus 3真菌药敏试剂盒。结果:共分离出真菌1 563株,2012、2013和2014年分别占全部送检标本的6.4%(439/6 852)、7.2%(444/6 189)和9.8%(680/6 919),真菌检出阳性率逐年升高(χ2=55.918,P0.05)。白假丝酵母菌构成比最高(49.9%),其次为光滑假丝酵母菌(17.5%)、热带假丝酵母菌(11.1%)和克柔假丝酵母菌(10.1%)。痰是真菌分离的主要标本类型(38.4%),其次为尿(18.2%)、便(15.5%)及引流液(6.8%)。白假丝酵母菌、光滑假丝酵母菌、热带假丝酵母菌和克柔假丝酵母菌对5-氟胞嘧啶均具有良好的敏感性,组间比较差异无统计学意义(P0.05)。而上述4种真菌对伏立康唑、氟康唑及伊曲康存在不同程度的耐药。结论:ICU患者真菌检出阳性率呈逐年增高的趋势。菌种以白假丝酵母菌为主,标本来源以痰为主,临床常见真菌对抗真菌药物存在一定的耐药性,应加强监测。
[Abstract]:Objective: to investigate the isolation and cultivation of fungal strains and their drug susceptibility in (ICU) patients in intensive care unit, and to provide evidence for the diagnosis and treatment of fungal infection. Methods: the fungi isolated from ICU patients in the first Hospital of Jilin University from January 2012 to December 2014 were collected. The distribution of fungi and the drug resistance of common strains were analyzed by retrospective study. VITEK-32 system was used for strain identification and Fungus 3 fungal susceptibility kit was used for drug sensitivity test. Results: a total of 1 563 strains of fungi were isolated in 2013 and 2014, which accounted for 6.4% (439 / 6 852) and 9.8% (680 / 6 919) of all samples, respectively. The positive rate of fungi detection increased year by year (蠂 ~ 2 / 55.918 P 0.05). The composition ratio of Candida albicans was the highest (49.9%), followed by Candida smooth (17.5%), Candida tropicalis (11.1%) and Candida krostri (10.1%). Sputum was the main specimen type (38.4%), followed by urine (18.2%), stool (15.5%) and drainage fluid (6.8%). Candida albicans, Candida smooth, Candida tropicalis and Candida cerevisiae had good sensitivity to 5-fluorocytosine (P0.05). The above four fungi were resistant to different degrees of voriconazole, fluconazole and itraconium. Conclusion the positive rate of fungi detection in ICU patients is increasing year by year. The strains were mainly Candida albicans and sputum was the main source of specimens. The drug resistance of common fungi antifungal drugs should be strengthened.
【作者单位】：吉林大学第一医院感染控制部;吉林大学第一医院检验科;
【基金】：吉林省科技厅科技发展计划基金资助课题(20150101220JC)
【分类号】：R446.5

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