2020-2024年深圳某医院曲霉菌分布及其对抗真菌药物的敏感性

Distribution and antifungal susceptibility of Aspergillus spp. in a hospital in Shenzhen from 2020 to 2024

  • 摘要:
    目的  研究曲霉菌的分布特征及其对抗真菌药物的敏感性, 以指导曲霉菌感染的治疗。
    方法  收集北京大学深圳医院2020年1月-2024年6月临床分离的非重复曲霉菌菌株的临床资料, 采用VITEK MS质谱检测系统进行菌种鉴定, 以YeastOne真菌药敏检测试剂盒检测最小抑菌浓度(MIC)和最低有效浓度(MEC)。
    结果  共收集非重复曲霉菌菌株864株, 烟曲霉的分离率最高(42.48%), 其次是黄曲霉(20.83%)、黑曲霉(15.74%)、聚多曲霉(14.24%)。标本主要来源于痰(58.33%)和支气管肺泡灌洗液(35.76%)。患者男性比例(53.82%)略高于女性(46.18%), 以60岁以上患者(57.98%)为主, 主要来自呼吸内科(47.45%)和重症医学科(16.09%)。烟曲霉和黄曲霉对卡泊芬净和米卡芬净的MEC90≤0.125 μg/ml, 土曲霉、黑曲霉以及构巢曲霉对卡泊芬净和米卡芬净的MEC≤0.125 μg/ml。
    结论  医院分离的曲霉菌以烟曲霉为主, 主要来自呼吸内科和重症医学科的老年男性人群, 唑类和棘白菌素类药物对曲霉菌具有良好敏感性, 烟曲霉对两性霉素B的敏感性较低。

     

    Abstract:
    OBJECTIVE  To investigate the distribution characteristics and antifungal sensitivity of Aspergillus spp., to optimize clinical treatment strategies for Aspergillosis.
    METHODS  Clinical data on non-duplicate Aspergillus spp. isolates were collected from Peking University Shenzhen Hospital between Jan. 2020 and Jun. 2024 and analyzed. The VITEK MS system was used for identification of strains, and the YeastOne fungal susceptibility test kit was employed to determine the minimum inhibitory concentration (MIC) and minimum effective concentration (MEC).
    RESULTS  A total of 864 strains of non-duplicate Aspergillus spp. were collected. The most common species identified were Aspergillus fumigatus (42.48%), followed by Aspergillus flavus (20.83%), Aspergillus niger (15.74%), and Aspergillus terreus (14.24%). Samples were primarily derived from sputum (58.33%) and bronchoalveolar lavage fluid (35.76%). The proportion of male (53.82%) was slightly higher than that of female (46.18%), and most patients were over 60 years old (57.98%), mainly from the department of respiratory medicine (47.45%) and the intensive care unit (16.09%). The MEC90 of A. fumigatus and A. flavus for caspofungin and micafungin was ≤0.125 μg/ml, and MEC of A. terreus, A. niger, and A. nidulans was all ≤0.125 μg/ml.
    CONCLUSIONS  The predominant Aspergillus spp. isolated from hospital is A. fumigatus, mainly from elderly male patients in the department of respiratory medicine and the intensive care unit. Aspergillus spp. demonstrates good sensitivity to azoles and echinocandins, while sensitivity of A. fumigatus to amphotericin B is relatively low.

     

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