系统性红斑狼疮患者深部真菌感染病原学分析与临床治疗研究

发布时间：2018-07-10 05:54

本文选题：系统性红斑狼疮 + 深部真菌感染　；参考：《中华医院感染学杂志》2015年08期

【摘要】：目的探讨系统性红斑狼疮继发深部真菌感染病原学诊断及抗菌药物应用,以期降低抗菌药物耐药性,提高临床诊治水平。方法选取2009年1月-2014年1月86例系统性红斑狼疮患者为研究对象,对其中并发深部真菌感染的患者进行病原菌和耐药性分析,采用SPSS13.0软件进行统计分析。结果 86例系统性红斑狼疮患者发生深部真菌感染16例,共培养出真菌37株,其中肺部有15株占40.54%,胃肠道7株占18.92%,其他15株占40.54%;检出真菌以白色假丝酵母菌、光滑假丝酵母菌、热带假丝酵母菌、新型隐球酵母菌为主,占78.38%;所有真菌均对两性霉素B、伏立康唑耐药性较低,在0~25.00%,新型隐球酵母菌对氟胞嘧啶、甲帕霉素耐药率较低,均为16.67%,光滑假丝酵母菌对球红霉素耐药率为12.50%,对其他抗真菌药物耐药率均较高,在50.00%~83.33%。结论系统性红斑狼疮继发深部真菌感染主要是条件致病菌,应用敏感抗菌药物及重视预防可提高预后。
[Abstract]:Objective to explore the etiological diagnosis and antimicrobial application of systemic lupus erythematosus secondary deep fungal infection in order to reduce antimicrobial resistance and improve the level of clinical diagnosis and treatment. Methods Eighty-six patients with systemic lupus erythematosus from January 2009 to January 2014 were studied. The pathogens and drug resistance of the patients complicated with deep fungal infection were analyzed by SPSS 13.0 software. Results in 86 patients with systemic lupus erythematosus, there were 16 cases of deep fungal infection and 37 strains of fungi were cultured, including 15 strains in lung (40.54%), 7 strains in gastrointestinal tract (18.922%), 15 strains in other 15 strains (40.54%), the fungi were detected by Candida albicans and Candida smooth. Candida tropicalis, a new Cryptococcus cerevisiae, accounted for 78.38.The resistance of all fungi to amphotericin B and voleconazole was low, and the resistance rate of new Cryptococcus cerevisiae to fluorocytosine and methopramycin was low at 25.00%. The resistance rates of Candida tropicalis to erythromycin were 12.50 and those to other antifungal agents were higher. Conclusion systemic lupus erythematosus secondary deep fungal infection is mainly a conditional pathogen, the use of sensitive antimicrobial agents and pay attention to prevention can improve the prognosis.
【作者单位】：安丘市人民医院风湿免疫科;安丘市人民医院药剂科;安丘市人民医院眼科;潍坊医学院附属医院风湿免疫科;
【基金】：山东省卫生厅基金资助项目(SW-2010B-016)
【分类号】：R593.241;R519

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