摘要
目的了解医院感染患者深部真菌感染的菌群分布及4种抗真菌药物的体外抗菌活性,为临床合理应用抗真菌药物提供帮助。方法常规培养分离真菌,用VITEK全自动微生物分析仪鉴定到种,药敏试验采用Rosco抗真菌药敏纸片扩散法及NCCLS M27-A肉汤稀释法。结果医院感染患者分离的9种156株深部真菌,以白色假丝酵母菌和热带假丝酵母菌为主,分别占57.69%、31.41%;临床感染标本的分离率以呼吸内科、心血管外科、神经内科为主,分别占26.28%、12.18%、9.62%;感染标本来源以呼吸道和泌尿道为主,占71.15%和16.67%;Rosco纸片扩散法对氟康唑、两性霉素B、伊曲康唑、酮康唑的耐药率分别为:23.08%、2.56%、12.18%、17.31%,MIC90分别为64.0、2.0、8.0、16.0mg/L。结论医院感染患者的深部真菌菌株以白色假丝酵母菌和热带假丝酵母菌为主,念珠菌属对常用抗真菌药物的耐药性有一定的差异,两性霉素B的抗菌活性最强,氟康唑的耐药性越来越高,临床应根据药敏试验结果合理应用抗真菌药物。
OBJECTIVE To understand flora distribution and four antifungal drugJin vitro antifungal activity of deep fungi in nosocomial infection in order to provide help to clinics. METHODS Fungi were cultured and isolated by routine procedure which identified by VITEK microbe automatic system. Drug susceptibility test used Rosco paper disk diffusion and broth dilution method with NCCLS M27-A. RESULTS Totally lg6 strains with 9 species of deep fungi that main fungi were Candida albican., and C. tropicalis with 57.69%, and 31.41%, respectively, were isolated from nosocomial infection. The major isolating rates of clinical infection specimens were from respiratory, cardiovascular surgery, and neurological departments with 26. 28%, 12. 18%, and 9. 62%, respectively. The main infection specimens were from respiratory tract and urinary tract with 71. 15% and 16.67M, respectively. Drug resistance rates to fluconazole, amphotericin B, itraconazole, and ketoconazole with Rosco paper disk diffusion were 23.08%, 2. 56%, 12. 18%, and 17.36%,MIC90 were 64. 0, 2.0, 8.0, and 16.0mg/L, respectively. CONCLUSIONS The main deep fungi are C. albicans and C. tropicalis. Antifungal activity of amphotericin B is the highest than others. The drug resistance rate to fluconazole is more and more higher. Clinics should use antifungal drug rationally in accordance with drug susceptibility test results.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2007年第3期349-351,共3页
Chinese Journal of Nosocomiology
关键词
医院感染
深部真菌
抗真菌药物
最低抑菌浓度
Nosocomial infection
Deep fungi
Antifungal drug
Minimum inhibitory concentration
