摘要
目的观察恶性肿瘤患者合并侵袭性肺部真菌感染(IPFI)病原菌分布及其耐药性的特点,为临床治疗提供依据。方法对医院78例诊断为恶性肿瘤合并IPFI的各种合格标本进行检测及药敏试验,对病原菌分布特点和耐药性进行分析。结果共检出各类真菌189株,第1位是假丝酵母菌属159株,占84.1%,其中白色假丝酵母菌检出率最高为104株占55.0%,热带假丝酵母菌31株占16.4%,光滑假丝酵母菌14株占7.4%,克柔假丝酵母菌10株占5.3%,曲霉菌属是第2大类真菌,检出23株,占12.2%;白色假丝酵母菌对氟康唑、伊曲康唑、伏立康唑、两性霉素B、卡帕芬净的耐药率均<10.0%;热带假丝酵母菌对伊曲康唑的耐药率22.6%;光滑假丝酵母菌对氟康唑、伊曲康唑的耐药率分别为21.4%、50.0%;克柔假丝酵母菌对氟康唑、伊曲康唑的耐药率分别为60.0%、50.0%。结论恶性肿瘤合并IPFI假丝酵母菌属占绝大多数,其中白色假丝酵母菌比例下降,非白色假丝酵母菌比例增多;所检出的真菌对常用抗真菌药物均存在不同程度的耐药性,部分真菌耐药性严重,提示应尽早进行病原学监测,并指导临床合理使用抗真菌药物。
OBJECTIVE To observe the distribution and drug resistance of the pathogens causing invasive pulmonary fungal infections（IPFI） in the patients with malignant tumor so as to provide basis for the clinical treatment.METHODS Totally 78 patients who diagnosed as the malignant tumor with IPFI were chosen as the study objects,the qualified specimens were detected and the drug susceptibility testing was performed.The distribution and drug resistance of the pathogenic bacteria were analyzed.RESULTS Totally 189 strains of fungi were isolated,there were 159（84.1%） strains of Candida,taking the first place,among which there were 104（55.0%） strains of C.albicans,31（16.4%） strains of C.tropicalis,14（7.4%） strains of C.glabrata,and 10（5.3%） strains of C.krusei;Aspergillus spp was the second species of the fungi,there were 23（12.2%） strains isolated.The drug resistance rates of C.albicans to fluconazole,itraconazole,voriconazole,amphotericin B,and kappa Finn net were less than 10.0%,the drug resistance rate of C.tropicalis to itraconazole was 22.6%,the drug resistance rates of C.glabrata to fluconazole and itraconazole were 21.4% and 50.0%,respectively,and the drug resistance rates of C.krusei to fluconazole and itraconazole resistant were 60.0% and 50.0%,respectively.CONCLUSION Candida are the majority of the pathogens causing IPFI in the patients with malignant tumor,among which C.albicans strains decrease and the non-C.albicans strains increase.All the isolated fungi vary in the drug resistance to commonly used antibiotics,the drug resistance of some of the fungi is serious,which indicated that the monitoring of etiology should be performed as early as possible and that the antibiotics should be used reasonably.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第22期5160-5161,共2页
Chinese Journal of Nosocomiology
基金
浙江省医学会临床科研基金项目(2008CYC56)
关键词
恶性肿瘤
肺部
真菌感染
耐药性
Malignant tumor
Lung
Fungal infections
Resistance
