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目的了解医院住院患者肺部感染真菌的分布及耐药情况,为临床合理选用抗真菌药物提供科学依据。方法通过临床标本真菌分离培养鉴定和药敏试验方法,对某医院住院肺部感染患者送检病原学标本进行检测与分析。结果从该医院住院肺部感染患者送检的病原学标本中共检出真菌685株,包括白假丝酵母菌539株,占78.69%;近平滑念珠菌86株,占21.31%。白假丝酵母菌感染患者的原发病主要是心肺合并症和慢性肺部感染性疾病;近平滑念珠菌感染患者原发病则主要是医疗相关性肺炎和心肺合并症。临床分离的真菌对伊曲康唑和氟康唑已经产生耐药,但对其他抗真菌药物敏感。结论住院患者肺部感染真菌以白假丝菌酵母菌为主,且对抗真菌药物已经产生耐药现象,应加强真菌感染监测。
Objective To understand the distribution and drug resistance of lung inpatients with fungal infection and provide a scientific basis for rational use of antifungal drugs in clinical practice. Methods The clinical specimens of fungi isolated and cultured identification and drug sensitivity test methods, a hospital inpatients with pulmonary infection etiology specimens for detection and analysis. Results A total of 685 fungi were detected in the etiological specimens from hospitalized patients with pulmonary infection, including 539 strains of Candida albicans (78.69%) and 86 strains of Candida parapsilosis (21.31%). Primary disease in patients with Candida albicans infection is mainly cardiopulmonary complications and chronic pulmonary infectious diseases; the main pathogenesis of patients with Candida parapsilosis is mainly medical-related pneumonia and cardiopulmonary complications. Clinically isolated fungi have been resistant to itraconazole and fluconazole, but are sensitive to other antifungal agents. Conclusions Infection of pulmonary infection in hospitalized patients with Candida albicans is the mainstay, and the antifungal agents have already developed drug resistance. The surveillance of fungal infections should be strengthened.