2013-2015年真菌血流感染病原真菌分布及药敏分析

发布时间：2018-04-04 20:07

本文选题：血流感染　切入点：真菌　出处：《中国感染与化疗杂志》2017年03期

【摘要】：目的了解血流感染常见病原真菌的菌群分布及药物敏感状况,评估(1,3)-β-D-葡聚糖检测(G试验)的临床价值,为临床真菌感染提供病原学诊断和合理使用抗真菌药物的依据。方法回顾性分析南京医科大学第一附属医院2013年1月-2015年12月真菌血流感染的的菌群分布及药物敏感状况,同步分析G试验检测结果。结果 3年共分离真菌114株,以念珠菌属为主(86.8%,99/114),其中以白念珠菌比例最高,占30.7%。真菌血流感染科室分布以胸外科、血液科、ICU多见,占41.2%,其中胸外科感染逐年减少(2013年5例10株,2014年2例5株,2015年3例4株),血液科和ICU在2014年最高,分别有11株和7株。药敏结果显示血流感染真菌对两性霉素B最为敏感,敏感率达到100%,对伊曲康唑敏感率最低,平均敏感率仅为83.5%。88例患者中54例进行了G试验检测,其中13例G试验先于血培养出现阳性结果。结论真菌血流感染以念珠菌属为主,抗真菌药物中两性霉素B的抗真菌活性最强,血培养与血清学试验联合检测,可给临床提供较早且可靠的诊断依据。
[Abstract]:Objective to investigate the distribution of pathogenic fungi and the drug sensitivity of common pathogenic fungi in blood stream infection, to evaluate the clinical value of the G test for the detection of 尾 -Dglucan, and to provide the basis for etiological diagnosis and rational use of antifungal drugs for clinical fungal infection.Methods the distribution and drug sensitivity of fungal blood stream infection in the first affiliated Hospital of Nanjing Medical University from January 2013 to December 2015 were analyzed retrospectively and the results of G test were analyzed simultaneously.Results 114 strains of fungi were isolated in 3 years, of which Candida was the most common, accounting for 30.7%, among which the proportion of Candida albicans was the highest (86.8%).Thoracic surgery was the most common department of fungal blood flow infection, accounting for 41.2%, among which thoracic infection decreased year by year (5 cases 10 strains in 2013, 2 cases 5 strains in 2014, 3 cases 4 strains in 2015). Hematology department and ICU were the highest in 2014, 11 strains and 7 strains, respectively.The results of drug sensitivity showed that infected fungi were the most sensitive to amphotericin B with a sensitivity rate of 100 and the lowest sensitivity to itraconazole. The average sensitivity rate was only 83.5.88 patients were tested by G test.Among them, 13 cases of G test showed positive results before blood culture.Conclusion the fungal blood stream infection is mainly Candida, and amphotericin B has the strongest antifungal activity in antifungal drugs. The combined detection of blood culture and serological test can provide early and reliable diagnostic basis for clinical application.
【作者单位】：镇江市中医院检验科;南京医科大学第一附属医院检验学部;
【基金】：江苏省实验诊断学重点实验室基金(xk201114) 南京医科大学“十二五”教育研究课题(JYY2015020)
【分类号】：R446.5;R519

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