2015~2017年某医院念珠菌感染及其耐药性分析

摘要/Abstract

摘要：

目的分析院内常见念珠菌感染的种类、分布及耐药情况，为临床医师合理用药方案提供一定依据。方法收集2015-2017年间甘肃中医药大学附属医院临床分离的720株念珠菌的相关资料，对其菌种分布及其对氟康唑、伊曲康唑、伏立康唑、两性霉素B及5-氟胞嘧啶的耐药情况进行回顾性分析。结果 720例念珠菌感染病例中，科室分布以老年病及肺病科为主，感染来源以下呼吸道感染为主。分离株以白念珠菌为主，其次为热带念珠菌和近平滑念珠菌；3年间菌种分布构成比差异无统计学意义（P=0.097）。白念珠菌对氟康唑、伏立康唑、伊曲康唑及两性霉素B的耐药性显著低于非白念珠菌（P<0.001），所有念珠菌对5-氟胞嘧啶均高度敏感，差异无统计学意义（P=0.217）。720株念珠菌中共有102例多重耐药株，其中以光滑念珠菌和克柔念珠菌的多重耐药率最高。5种抗真菌药物耐药率均显著正相关（P<0.001），其中以氟康唑和伏立康唑相关性最强（r=0.828）。结论白念珠菌仍为院内感染的主要分离念珠菌，3年间分离率无明显变化；白念珠菌与非白念珠菌耐药性差异较大，且非白念珠菌多重耐药率较高，临床用药时应合理选择抗真菌药物治疗。

关键词: 念珠菌, 分布特点, 耐药性分析

Abstract:

Objective To explore the species distribution and drug resisitance of Candida infection in our hospital from Jan. 2015 to Dec. 2017, and to provide etiological basis for clinical rational use of antifungal agents. Method All the data of patients with Candida infection including gender, age, organism, specimen type, department distribution and drug residence from Jan. 2015 to Dec were retrospectively collected. Result Total 720 Candida isolates mainly came from Geriatric department and Pulmonary department. C. albicans was the most common one, followed by C. tropicalis and C. parapsilosis. The main site of infection was respiratory tracts. There was no difference in the distributions of species from 2015 to 2017. The resistance of Candida albicans to fluconazole, voriconazole, itraconazole and amphotericin B was lower than that of non-Candida albicans (P<0.001). There were 102 multi-drug resistant strains in 720 Candida isolates, among which C. glabrata and C.krusei had the highest multi-drug resistance rates. Conclusion Candida albicans was still the main isolate of Candida, and there is no significant change in the isolation rates during three years; the drug resistance of Candida albicans and non-Candida albicans was different, and the multi-drug resistance rate of non-Candida albicans was higher than that of C. albicans. Clinical antifungal therapy should be based on the results of antifungal susceptibility test.

Key words: Candida, drug resistance, species distribution

中图分类号:

R519.3

田洹. 2015~2017年某医院念珠菌感染及其耐药性分析[J]. 中国真菌学杂志, 2019, 14(1): 37-41.

TIAN Huan. Candida infection and drug resistance in a hospital from 2015 to 2017[J]. Chinese Journal of Mycology, 2019, 14(1): 37-41.

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