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目的分析肝病患者真菌感染的特点和耐药性,为临床预防真菌感染和合理用药提供依据。方法回顾分析2011年1月—2014年6月临床分离的1472株真菌的组成及耐药性。结果肝病患者真菌感染的主要标本来源是痰、中段尿和腹水。菌种以白假丝酵母菌为主(54.96%),其次是烟曲霉菌(13.25%),热带假丝酵母菌和光滑假丝酵母菌分别为10.39%和10.26%。丝状真菌对抗真菌药的耐药率明显高于酵母菌(P=0.000)。对氟康唑的耐药率较高的为烟曲霉菌(100%)、克柔假丝酵母菌(81.67%)和光滑假丝酵母菌(24.50%),克柔假丝酵母菌对伊曲康唑的耐药率达16.67%,白假丝酵母菌的药物敏感性较好。结论肝病患者真菌感染以白假丝酵母菌为主,其次是烟曲霉菌。不同种的真菌对不同抗真菌药的敏感性不同,临床应根据患者真菌感染和耐药特点合理治疗。
Objective To analyze the characteristics and drug resistance of fungal infections in patients with liver diseases and provide the basis for clinical prevention of fungal infections and rational drug use. Methods The composition and drug resistance of 1472 fungi clinically isolated from January 2011 to June 2014 were retrospectively analyzed. Results The main source of fungal infection in patients with liver disease was sputum, middle urine and ascites. Candida albicans was dominant (54.96%), followed by Aspergillus fumigatus (13.25%), Candida tropicalis and Candida glabrata were 10.39% and 10.26%, respectively. The resistance rate of filamentous fungi to fungals was significantly higher than that of yeasts (P = 0.000). The higher rates of resistance to fluconazole were Aspergillus fumigatus (100%), Candida krusei (81.67%) and Candida glabrata (24.50%), Candida krusei The drug resistance rate of conazole reached 16.67%. The drug sensitivity of Candida albicans was better. Conclusions Fungal infection in patients with liver disease is mainly Candida albicans, followed by Aspergillus fumigatus. Different kinds of fungi have different sensitivity to different antifungal agents, and should be reasonably treated according to the characteristics of fungal infections and drug resistance in patients.