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目的了解住院肺癌患者感染假丝酵母菌属的菌种分布特点及抗菌药物敏感性分析,为临床合理应用抗菌药物提供科学依据。方法回顾分析2008年-2012年唐山人民医院住院肺癌患者感染假丝酵母菌属的菌种分布及其对5种常用抗真菌药物的敏感性。药敏试验按CLSI M27—A2标准中的稀释法操作。结果肺癌患者在痰液、尿液、粪便、血液标本中假丝酵母菌的检出率均呈逐年上升趋势。白假丝酵母菌为优势菌种,但其所占分离菌株的比例呈逐年下降趋势,从2008年的59.0%下降至2012年的47.9%;而非白假丝酵母菌所占的比例逐年增加,从2008年的41.1%增加至2012年的52.2%。药敏结果伏立康唑的敏感率最高,5-氟胞嘧啶、两性霉素B的敏感率次之,对氟康唑、伊曲康唑的敏感率不理想。结论临床医生应重视肺癌患者合并假丝酵母菌感染的检测及种类变迁的监测,根据药敏试验结果,合理选用抗真菌药物,能有效控制感染。
Objective To understand the distribution of Candida spp. In hospitalized lung cancer patients and the analysis of antibacterial susceptibility, so as to provide a scientific basis for rational use of antibacterials in clinic. Methods The distribution of Candida species inoculated with lung cancer and the sensitivity to five commonly used antifungal agents in hospitalized patients with lung cancer in Tangshan People’s Hospital from 2008 to 2012 were retrospectively analyzed. Susceptibility testing according to CLSI M27-A2 standard dilution method. Results The detection rate of Candida albicans in sputum, urine, stool and blood samples showed an upward trend year by year. Candida albicans was the predominant species, but the share of isolates was declining year by year, from 59.0% in 2008 to 47.9% in 2012, while the proportion of non-Candida albicans increased year by year From 41.1% in 2008 to 52.2% in 2012. Susceptibility results of voriconazole the highest susceptibility, 5-fluorocytosine, amphotericin B, followed by the sensitivity rate of fluconazole, itraconazole sensitivity is not ideal. Conclusion Clinicians should pay more attention to the detection of Candida albicans infection in lung cancer patients and the monitoring of the changes of their types. According to the result of drug susceptibility test, rational use of antifungal agents can effectively control the infection.