血液病合并侵袭性真菌感染病原学及危险因素

发布时间：2018-11-27 21:29

【摘要】：目的了解血液病合并侵袭性真菌感染(IFI)的现状,分析真菌耐药情况及感染的危险因素。方法回顾性分析2006—2010年某院血液病科合并感染的患者1 246例次,对IFI患者病原学特点及危险因素进行分析。结果真菌感染281例次,分离真菌162株,感染部位以呼吸道(134株,占82.72%)为主。4种主要酵母菌为白假丝酵母菌、热带假丝酵母菌、光滑假丝酵母菌和克柔假丝酵母菌;2006—2009年均以白假丝酵母菌为主,2010年非白假丝酵母菌超过白假丝酵母菌。4种主要酵母菌对氟康唑和伊曲康唑的总耐药率分别为5.15%和4.41%,6株克柔假丝酵母对氟康唑和伊曲康唑全部耐药,未发现对伏立康唑耐药的菌株。真菌感染的独立危险因素为合并糖尿病、粒缺时间14 d。结论血液病患者非白假丝酵母菌感染比例增加,出现了耐氟康唑和伊曲康唑的非白假丝酵母菌,需采取综合措施积极预防及早期治疗IFI患者。
[Abstract]:Objective to investigate the status of (IFI) in hematologic diseases complicated with invasive fungal infection, and to analyze the drug resistance of fungi and the risk factors of infection. Methods A retrospective analysis was made on 1 246 cases of hematological diseases complicated with infection in a hospital from 2006 to 2010. The etiological characteristics and risk factors of patients with IFI were analyzed. Results 162 strains of fungi were isolated from 281 cases of fungal infection. The main infection sites were respiratory tract (134 strains, 82.72%). The four main yeast species were Candida albicans, Candida tropicalis, Candida smooth Candida and Candida krostri. In 2006-2009, the main yeasts were Candida albicans. In 2010, non-Candida cerevisiae exceeded Candida albicans. The total drug resistance rates of four major yeasts to fluconazole and itraconazole were 5.15% and 4.41%, respectively. All 6 strains of Candida krolimus were resistant to fluconazole and itraconazole. The independent risk factor for fungal infection was diabetes mellitus, with a duration of 14 days. Conclusion the infection rate of non-white Candida cerevisiae in patients with hematologic diseases was increased, and fluconazole-resistant and itraconazole-resistant non-white Candida cerevisiae were found. It is necessary to take comprehensive measures to prevent and treat the patients with IFI at an early stage.
【作者单位】：海军总医院;青岛大学附属医院;
【分类号】：R519

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