论文部分内容阅读
目的了解肿瘤病人合并真菌感染的情况及耐药性分析,为临床合理使用抗生素提供依据,有效预防和控制院内感染。方法采用回顾性调查方法,对湖南省肿瘤医院2010年1月-2012年12月肿瘤住院病人真菌感染的情况及药敏结果进行分析。结果 2010年1月-2012年12月共收集肿瘤住院患者临床分离病原菌1 706株,其中真菌466株,占27.3%(其中2010年分离病原菌532株,真菌113株,占21.2%;2011年分离病原菌585株,真菌172株,占29.4%;2012年分离病原菌589株,其中真菌181株,占30.7%),且三年间真菌检出率呈逐年上升趋势(χ2=14.63,P<0.05)。真菌感染的标本以呼吸道标本为主,占77.9%,其次为泌尿生殖道标本,占11.8%,真菌感染以白色假丝酵母菌为主,占69.7%。466株真菌对两性霉素B全敏感,对5-氟胞嘧啶耐药率<10.0%。对唑类药物耐药率较高,除克柔念珠对氟康唑耐药率84.6%,伊曲康唑耐药率46.2%外,其他耐药率均<30.0%。2010-2012年所有真菌对5-氟胞嘧啶、氟康唑、伊曲康唑耐药率均有上升(P<0.05)。结论肿瘤患者真菌感染逐年上升,应加强肿瘤患者真菌感染的病原菌检测和药敏试验,有效控制院内感染。
Objective To understand the situation of patients with tumor complicated with fungal infection and drug resistance analysis to provide a basis for the rational use of antibiotics in clinical and effective prevention and control of nosocomial infections. Methods A retrospective survey was conducted to analyze the prevalence of fungal infections in patients with cancer inpatients from January 2010 to December 2012 in Hunan Tumor Hospital and the drug susceptibility results. Results A total of 1 706 clinical isolates from hospitalized patients with cancer were collected from January 2010 to December 2012, of which 466 were fungi (27.3%), of which 532 were isolated from pathogens in 2010 and 113 were fungi (21.2% 585 strains were pathogenic bacteria and 172 were fungi, accounting for 29.4%. 589 strains of pathogens were isolated in 2012, of which 181 were fungi (30.7%). The detection rate of fungi increased year by year (χ2 = 14.63, P <0.05). The specimens of fungal infections were mainly respiratory specimens, accounting for 77.9%, followed by genitourinary tract specimens, accounting for 11.8%. Candida albicans was the main fungal infection, accounting for 69.7%. 466 strains were completely sensitive to amphotericin B and resistant to 5-fluorocytosine <10.0%. The rates of resistance to azole were higher than those of fluconazole (84.6%) and the rate of itraconazole (46.2%). All other resistance rates were less than 30.0%. The resistance rates of all fungi to 5-fluorocytosine, fluconazole and itraconazole increased from 2010 to 2012 (P <0.05). Conclusions The fungal infection in cancer patients increases year by year. The detection of pathogenic bacteria and drug susceptibility testing of fungal infections in cancer patients should be strengthened to effectively control nosocomial infections.