ICU患者感染念珠菌的临床分布及体外药敏分析
Distribution and drug susceptibility of clinical Candida cases from ICU
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摘要: 目的 了解ICU患者感染念珠菌的临床分布特点及药物敏感性,以指导临床合理使用抗真菌药物减少侵袭性真菌病(IFD)的发生,降低其病死率。方法 对2013年1月-2014年12月ICU患者送检5 892份标本中分离出346株念珠菌进行回顾性分析,念珠菌用CHROMagar显色培养基鉴定,疑难菌株用API 20C AUX鉴定板鉴定,采用ATB FUNGUS 3药敏板进行药敏检测。结果 从ICU送检的各类标本中分离出念珠菌346株,以白色念珠菌的检出率居首位,检出204株占59.0%,其余为近平滑念珠菌47株占13.6%、热带念珠菌40株占11.6%等;药敏结果显示,5-氟胞嘧啶、两性霉素B对念珠菌属的敏感率高,但唑类药物敏感率在不同种的念珠菌中的体外药敏试验结果有一定的差异。结论 必须重视念珠菌的培养鉴定和体外药敏数据分析,合理选用抗真菌药。Abstract: OBJECTIVE To analyze the distribution and drug resistance of clinical Candidacases from intensive care unit(ICU),so as to guide the rational clinical drug use and to reduce the incidence and mortality of invasive fungal disease(IFD).METHODS A total of 346 strains of Candidastrains isolated from ICU from Jan.2013 to Dec.2014 were retrospectively analyzed.Candida were identified by CHROMagar and API 20 C AUX strips,and the drug resistant test were detected with the ATB 3FUNGUS strips.RESULTS Totally 346 strains of Candida were identified from ICU.Among all strains of Candida,Candida albicans was the most(204strains,59.0%),and followed by Candida parapsilosis(47strains,13.6%),and Candida tropicalis(40strains,11.6%).The susceptibility tests showed that Candidahad lower resistance to 5-fluorocystine and amphotricin B,but there was statistical difference in the susceptibility of Candidaspecies to fluconazole and itraconazole.CONCLUSION It is imperative to test strain identification and susceptibility of Candidaspecies,for the rational use of antifungal drugs.
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