河北地区侵袭性酵母菌感染的分布特征

Epidemiological characteristics of invasive yeast infection in Hebei province

  • 摘要: 目的 调查河北地区15家三级教学医院2016-2017年侵袭性酵母菌感染现状,了解河北地区侵袭性酵母菌感染的流行病学分布特点。方法 对临床检出侵袭性酵母菌进行菌株收集和统计,采用科玛嘉显色培养基和VITEK-2 Compact YST卡进行菌种初筛鉴定; 应用微生物质谱对所有菌株进行复核鉴定,对于疑难及少见菌株进行ITS测序分析。结果 2016-2017年15家三级教学医院共检出侵袭性酵母菌样真菌268株。其中以白假丝酵母为主,112株占41.79%,其次为热带假丝酵母52株占19.40%,近平滑假丝酵母38株占14.18%; 标本类型包括血液标本131株占48.88%,无菌体液标本137株占51.12%; 内科科室(血液科、肿瘤科、呼吸科)69株占25.75%,外科科室(普外科、神经外科)67株占25.00%; ICU 55株占20.52%; 菌株复核正确率为83.96%(225/268)。结论 侵袭性酵母菌感染中最常见的仍然是白假丝酵母,但是非白假丝酵母感染有不同程度的上升趋势。采用质谱检测可以有效提高疑难菌株的鉴定正确率,为临床治疗提供精准的病原学依据。

     

    Abstract: OBJECTIVE To investigate the current status of invasive yeast infection in 15 tertiary teaching hospitals in Hebei province from 2016 to 2017 so as to understand the epidemiological characteristics of the invasive yeast infection in Hebei province. METHODS The invasive yeast strains that were isolated from clinical department were collected and statistically analyzed, and the strains were preliminarily screened and identified by using Chromogenic medium CHROMagar and Compact YST card, all of the strains were re-examined and identified by using microorganism mass spectrum, and the ITS sequencing analysis was performed for the difficult and rare strains. RESULTS Of totally 268 strains of invasive yeast-like fungi that were isolated from 15 tertiary hospitals between 2016 and 2017, 112 (41.79%) were Candida albicans, 52 (19.40%) were Candida tropicalis, and 38 (14.18%) were Candida parapsilosis.131 (48.88%) were isolated from blood specimens, 137 (51.12%) strains were isolated from aseptic body fluid specimens.69 (25.75%) strains were isolated from internal medicine departments (hematology department, oncology department, respiratory medicine department), 67 (25.00%) strains were isolated from surgical departments (general surgery department, neurosurgery department), and 55 (20.52%) strains were isolated from ICU.The correct rate of reexamination of the strains was 83.96% (225/268). CONCLUSION C.albicans remain the predominant species of invasive yeast, however, the incidence of infection caused by non-C.albican strains is increased unevenly.Mass spectrometry may effectively raise the correct rate of identification of difficult strains so as to provide etiological basis for clinical treatment.

     

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