2019—2021年四川省血流感染病原真菌分布特征及药敏分析

中国真菌学杂志　 2023, Vol. 18 　Issue (3): 198-204,210.

2019—2021年四川省血流感染病原真菌分布特征及药敏分析

邓劲¹, 殷琳², 江海燕³, 旷凌寒⁴, 彭溪⁵, 杨向贵⁶, 倪苏娇⁷, 张帮勤⁸, 冯金芳⁹, 王燕玲¹⁰, 马瑜珊¹¹, 陈宗耀¹², 钟涵宇¹³, 吴贤丽¹⁴, 黎昆¹⁵, 王玲¹⁶, 高伟¹⁷, 杨学强¹⁸, 朱军¹⁹, 陈喻²⁰, 张弦²¹, 孙昌君²², 罗军²³, 李玉梅²⁴, 李彦²⁵, 张兵²⁶, 谢宁²⁷, 王俊²⁸, 谢轶¹, 康梅¹

1. 四川大学华西医院实验医学科(检验科), 成都 610000;
2. 四川省医学科学院·四川省人民医院, 成都 610000;
3. 广安市人民医院, 广安 638500;
4. 四川大学华西第二医院, 成都 610000;
5. 成都市第三人民医院, 成都 610000;
6. 成都医学院第一附属医院, 成都 610000;
7. 四川省肿瘤医院, 成都 610000;
8. 西南医科大学附属医院, 泸州 646000;
9. 广元市中心医院, 广元 628000;
10. 乐山市人民医院, 乐山 614000;
11. 绵阳市第三人民医院, 绵阳 621000;
12. 德阳市人民医院, 德阳 618000;
13. 内江市第一人民医院, 内江 641000;
14. 攀枝花市中心医院, 攀枝花 617000;
15. 遂宁市中心医院, 遂宁 629000;
16. 西昌市人民医院, 西昌 615000;
17. 雅安市人民医院, 雅安 625000;
18. 宜宾市第二人民医院宜宾 644000;
19. 资阳市第一人民医院, 资阳 641300;
20. 自贡市第一人民医院, 自贡 643000;
21. 成都市第二人民医院, 成都 610000;
22. 达州市中心医院, 达州 635000;
23. 绵阳市中心医院, 绵阳 621000;
24. 自贡市第四人民医院, 自贡 643000;
25. 眉山市人民医院, 眉山 620000;
26. 南充市中心医院, 南充 637000;
27. 川北医学院附属医院, 南充 637000;
28. 攀枝花市中西医结合医院, 攀枝花 617000

收稿日期:2022-05-06 出版日期:2023-06-28 发布日期:2023-07-08
通讯作者: 康梅,E-mail:kangmei@sina.com E-mail:kangmei@sina.com
作者简介:邓劲,男(汉族),本科,主管检验师.E-mail:664256097@qq.com

Pathogenic distribution characteristics of fungal bloodstream infection in Sichuan Province from 2019 to 2021

DENG Jin¹, YIN Lin², JIANG Haiyan³, KUANG Linghan⁴, PENG Xi⁵, YANG Xianggui⁶, NI Sujiao⁷, ZHANG Bangqin⁸, FENG Jinfang⁹, WANG Yanling¹⁰, MA Yushan¹¹, CHEN Zongyao¹², ZHONG Hanyu¹³, WU Xianli¹⁴, LI Kun¹⁵, WANG Ling¹⁶, GAO Wei¹⁷, YANG Xueqiang¹⁸, ZHU Jun¹⁹, CHEN Yu²⁰, ZHANG Xian²¹, SUN Changjun²², LUO Jun²³, LI Yumei²⁴, LI Yan²⁵, ZHANG Bin²⁶, XIE Ning²⁷, WANG Jun²⁸, XIE Yi¹, KANG Mei¹

1. Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu 610000;
2. Sichuan Provincial People's Hospital, Chengdu 610000;
3. Guang'an People's Hospital, Guang'an 638500;
4. West China Second Hospital of Sichuan University, Chengdu 610000;
5. Chengdu Third People's Hospital, Chengdu 610000;
6. The First Affiliated Hospital of Chengdu Medical College, Chengdu 610000;
7. Sichuan Cancer Hospital, Chengdu 610000;
8. Affiliated Hospital of Southwest Medical University, Luzhou 646000;
9. Guangyuan Central Hospital, Guangyuan 628000;
10. Leshan People's Hospital, Leshan 614000;
11. Mianyang Third People's Hospital, Mianyang 621000;
12. Deyang City People's Hospital, Deyang 618000;
13. Neijiang First People's Hospital, Neijiang 641000;
14. Panzhihua Central Hospital, Panzhihua 617000;
15. Suining Central Hospital, Suining 629000;
16. Xichang Municipal People's Hospital, Xichang 615000;
17. Ya'an Municipal People's Hospital, Ya'an 625000;
18. Yibin Second People's Hospital Yibin 644000;
19. Ziyang First People's Hospital, Ziyang 641300;
20. Zigong First People's Hospital Zigong 643000;
21. Chengdu Second People's Hospital, Chengdu 610000;
22. Dazhou Central Hospital, Dazhou 635000;
23. Mianyang Central Hospital, Mianyang 621000;
24. Zigong Fourth People's Hospital, Zigong 643000;
25. Meishan People's Hospital, Meishan 620000;
26. Nanchong City Central Hospital, Nanchong 637000;
27. Affiliated Hospital of North Sichuan Medical College, Nanchong 637000;
28. Panzhihua Hospital of Integrated Traditional Chinese and Western Medicine, Panzhihua 617000

Received:2022-05-06 Online:2023-06-28 Published:2023-07-08

摘要/Abstract

摘要： 目的收集全国真菌病监测网四川省中心真菌血流感染数据,整理分析病原菌分布特点及抗真菌药物敏感性情况,为四川省真菌血流感染提供流行病学数据。方法研究28家医院2019年1月1日—2021年12月31日门急诊及住院患者真菌血流感染的数据,采用Whonet 5.6及Microsoft Excle数据透视表功能分析真菌血流感染的临床资料及实验室信息。结果 2019年1月1日—2021年12月31日28家医院上报数据中的1 220株真菌中,念珠菌属占88.8%(1 083/1 220),以白念珠菌为主,占35.3%(431/1 220);新生隐球菌位于总分离株数的第5位,占8.3%(101/1 220)。男性占比56.6%(690/1220),女性患者相比较少(43.4%,530/1 220);其中中老年患者(>46岁)79.8%,34.8%来自于重症监护室。白念珠菌对氟康唑的敏感性最高(85.7%);热带念珠菌对氟康唑和伏立康唑的耐药率分别为43.4%和43.3%,且逐年上升。分离的101株新生隐球菌对两性霉素B、氟胞嘧啶、氟康唑、伏立康唑和伊曲康唑均存在不同的非野生株,比例分别为5.0%、2.5%、11.8%、5.7%和8.5%;每家医院分离病原菌的数量排序存在一定差异,大多数医院以白念珠菌为主,但儿童专科性医院近平滑念珠菌分离数最多。结论真菌血流感染病原菌及其抗真菌药物敏感性存在地域性特点,准确掌握所在地区病原菌流行病学资料可以为临床选择抗真菌药物提供依据。

关键词: 真菌血流感染, 病原菌, 抗真菌药物敏感性, 分布特征, 流行病学

Abstract: Objective To collect the fungal bloodstream infection data from the Sichuan Provincial Center of China Fungal Disease Surveillance System, to analyze the distribution characteristics and the susceptibility to antifungal drugs of pathogens, and to provide epidemiological data for fungal bloodstream infections in Sichuan Province. Methods The data of outpatient, emergency, and inpatient fungal bloodstream infections in 28 hospitals from January 1, 2019, to December 31, 2021, were studied. The clinical and laboratory data of fungal bloodstream infection were analyzed using Whonet 5.6 and Microsoft Excle pivot table. information. Results From January 1, 2019, to December 31, 2021, Candida accounted for 88.8% (1083/1 220) of the 1 220 fungal strains was reported by 28 hospitals. Candida albicans was the main species, accounting for 35.3% (431/1 220).and Cryptococcus neoformans being fifth in the total number of isolates, accounting for 8.3% (101/1 220). Males accounted for 56.6% (690/1 220), and female patients were less (43.4%, 530/1 220); 79.8% cases were middle-aged and elderly patients (>46 years old) and 34.8% cases were from the intensive care unit. C. albicans had the highest sensitivity to fluconazole (85.7%); resistance rates of C.tropicalis to fluconazole and voriconazole were 43.4% and 43.3%, respectively. by C. albicans isolates were dominated in Most hospitals, however, C. parapsilosis was mostly isolated in children's specialized hospitals. Conclusion The pathogens of fungal bloodstream infection and their antifungal drug susceptibility have regional characteristics. Accurately grasping the epidemiological data in the region can provide a basis for the clinical selection of antifungal drugs.

Key words: fungal bloodstream infection, pathogenic fungi, antifungal drug susceptibility, distribution characteristics, epidemiology

中图分类号:

R 519

邓劲, 殷琳, 江海燕, 旷凌寒, 彭溪, 杨向贵, 倪苏娇, 张帮勤, 冯金芳, 王燕玲, 马瑜珊, 陈宗耀, 钟涵宇, 吴贤丽, 黎昆, 王玲, 高伟, 杨学强, 朱军, 陈喻, 张弦, 孙昌君, 罗军, 李玉梅, 李彦, 张兵, 谢宁, 王俊, 谢轶, 康梅. 2019—2021年四川省血流感染病原真菌分布特征及药敏分析[J]. 中国真菌学杂志, 2023, 18(3): 198-204,210.

DENG Jin, YIN Lin, JIANG Haiyan, KUANG Linghan, PENG Xi, YANG Xianggui, NI Sujiao, ZHANG Bangqin, FENG Jinfang, WANG Yanling, MA Yushan, CHEN Zongyao, ZHONG Hanyu, WU Xianli, LI Kun, WANG Ling, GAO Wei, YANG Xueqiang, ZHU Jun, CHEN Yu, ZHANG Xian, SUN Changjun, LUO Jun, LI Yumei, LI Yan, ZHANG Bin, XIE Ning, WANG Jun, XIE Yi, KANG Mei. Pathogenic distribution characteristics of fungal bloodstream infection in Sichuan Province from 2019 to 2021[J]. Chinese Journal of Mycology, 2023, 18(3): 198-204,210.

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