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通过对8年间分离的1116株酵母样真菌的分类、标本来源、及其对抗真菌药物敏感试验结果的分析,初步探讨了酵母样真菌与院内不同部位深部真菌感染之间的关系。结果表明:白色念珠菌及热带念珠菌是导致医院内深部真菌感染的重要病原菌(分别占53.58%和27.24%),感染部位依次为呼吸道、消化道、泌尿道、腹腔、血液及中枢神经系统(80.73%、12.01%、3.32%、1.70%、1.79%、0.45%)。体外药物敏感试验结果表明:真菌对临床常用的抗真菌药物大都敏感,但耐药性也不容忽视,耐药率分别为AMB37%、5-FC47%、KCZ12%、NYS61%、FCZ15%,随着抗真菌药物应用增多,给耐药菌提供选择压力,使耐药性随之增加。合理应用抗真菌药物是一亟待加强的问题,本研究还发现院内深部真菌感染者中大部分为接受一周以上抗生素治疗的病人,表明合理应用抗生素,防止菌群失调是预防医院内深部真菌感染的重要因素之一。
Based on the classification of 1116 yeast-like fungi isolated from the past eight years, the origin of the specimens and the analysis of their antifungal susceptibility test results, the relationship between yeast-like fungi and deep fungal infections in different parts of the hospital was discussed. The results showed that Candida albicans and Candida tropicalis were the important pathogenic bacteria causing deep fungal infection in the hospital (53.58% and 27.24% respectively). The infected sites were respiratory tract, digestive tract, urinary tract, abdominal cavity, blood and Central nervous system (80.73%, 12.01%, 3.32%, 1.70%, 1.79%, 0.45%). In vitro drug susceptibility test results show that: fungi commonly used in clinical antifungal agents are mostly sensitive, but the drug resistance can not be ignored, the resistance rates were AMB37%, 5-FC47%, KCZ12%, NYS61%, FCZ15%, with Increased use of anti-fungal drugs, drug-resistant bacteria to provide selective pressure, so that drug resistance increases. Rational use of antifungal drugs is an urgent need to be strengthened, the study also found that most of the hospital deep fungal infections in patients receiving more than one week of antibiotics, indicating that the rational use of antibiotics to prevent bacterial flora is to prevent deep fungal infections in the hospital One of the important factors.