川南地区侵袭性念珠菌感染流行病学及耐药性分析

摘要/Abstract

摘要： 目的分析侵袭性念珠菌感染的菌种分布，样本类型和抗真菌药物的敏感性等数据，为临床诊治提供依据。方法回顾性分析本单位2014年1月—2019年12月临床诊断为侵袭性念珠菌感染的患者临床资料，对菌种分布、样本类型、科室分布和抗真菌药敏感性等进行分析。结果共收集非重复性侵袭性念珠菌感染患者646例，男性355例，占54.95%，大于60岁患者占55.11%；其中白念珠菌314株（48.61%），其次是光滑念珠菌226株（34.98%）和热带念珠菌71株（10.99%）；以2017年感染病例最多（141例，21.83%），之后呈下降趋势；感染样本类型以创口深部分泌物（229例，35.45%）为主；其次是清洁尿液（174例，26.93%）和血液（117例，18.11%），侵袭性念珠菌感染前3位科室是内科（255例，39.47%），外科（214例，33.13%），儿科（78例，12.07%）；所有念珠菌对氟康唑、伊曲康唑和伏立康唑总耐药率分别为18.82%、36.15%和19.38%，对两性霉素B和5-氟胞嘧啶的敏感性均为100.00%。结论本地区侵袭性念珠菌感染以老年患者和白念珠菌为主，但非白念珠菌占主要地位，念珠菌对唑类抗真菌药物耐药率较高，但对两性霉素B和5-氟胞嘧啶保持高度敏感性。

关键词: 侵袭性感染, 念珠菌, 流行病学, 抗真菌药物敏感性, 回顾性分析

Abstract: Objective To analyze species distribution, sample types and antifungal susceptibility of invasive Candida infection, to provide basis for clinical diagnosis and treatment. Methods The clinical data of patients with invasive Candida infection were retrospectively analyzed in the Affiliated Hospital of Southwest Medical University from January 2014 to December 2019. Results A total of 646 patients with non-repetitive invasive Candida infection were collected, including 355 males (54.95%) and patients over 60 years old (55.11%). The main isolates of Candida species were Candida albicans (314, 48.61%), followed by Candida glabrata (226, 34.98%) and Candida tropicalis (71, 10.99%). The number of infection patients was the highest in 2017 (141 cases, 21.83%), and then showed a downward trend. The main specimen types were deep wound secretion (229 cases, 35.45%), followed by clean urine (174 cases, 26.93%) and blood (117 cases, 18.11%). The top three departments of invasive Candida infection were internal medicine (255 cases, 39.47%), surgery (214 cases, 33.13%) and pediatrics (78 cases, 12.07%). The total resistance rates of all Candida species to fluconazole, itraconazole and voriconazole were 18.82%, 36.15% and 19.38%, respectively, and the susceptibilities of amphotericin B and 5-flucytosine was 100.00%. Conclusions Candida albicans was the main invasive infection species in this area and elderly patients were the main infected group.Non-Candida albicans was the main Candida species. Candida species were highly resistant to azole antifungal drugs, but highly sensitive to amphotericin B and 5-flucytosine.

Key words: invasive infection, Candida, epidemiology, antifungal susceptibility test, retrospective analysis

中图分类号:

R519.3

徐灵玲, 曾章锐, 丁银环, 杨葵. 川南地区侵袭性念珠菌感染流行病学及耐药性分析[J]. 中国真菌学杂志, 2021, 16(5): 319-325.

XU Lingling, ZENG Zhangrui, DING Yinhuan, YANG Kui. The epidemiology and antifungal susceptibility of invasive Candida isolates in Southern Sichuan[J]. Chinese Journal of Mycology, 2021, 16(5): 319-325.

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