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目的探讨重症患者假丝酵母菌属感染与药物敏感性,旨在为临床用药提供指导依据。方法 2010年1月-2014年12月入住ICU假丝酵母菌属培养阳性的重症患者312例,收集患者痰液、血液、中段尿、手术切口分泌物等,分析感染假丝酵母菌属分布与耐药性。结果 5年中,ICU重症患者假丝酵母菌属感染检出率为14.7%,且呈现逐年上升的趋势,差异有统计学意义(P<0.05);312株假丝酵母菌属包括白色假丝酵母菌占47.1%,光滑假丝酵母菌占33.7%,热带假丝酵母菌占13.5%,克柔假丝酵母菌占3.2%,近平假丝酵母菌和葡萄牙假丝酵母菌各占1.3%;假丝酵母菌属主要来自重症患者痰液181株占58.0%、尿液41株占13.1%、分泌物27株占8.7%;假丝酵母菌属对抗菌药物的耐药性以伊曲康唑最高为13.6%,依次为伏立康唑、氟康唑、氟胞嘧啶,对两性霉素B的耐药性为0;克柔假丝酵母菌、近平假丝酵母菌与葡萄牙假丝酵母菌对5种抗菌药物的耐药性均为0。结论重症患者假丝酵母菌属感染呈逐渐上升的趋势,主要发生于呼吸道,对两性霉素B敏感,对伊曲康唑耐药性高。
Objective To investigate the Candida infection and drug susceptibility in critically ill patients and to provide guidance for clinical use. Methods From January 2010 to December 2014, 312 patients with ICU Candida positive were included in this study. Sputum, blood, middle urine and surgical incision secretions of patients were collected. The distribution of Candida spp. Resistance. Results The prevalence of Candida infections in critically ill patients with ICU was 14.7% in 5 years, and showed a trend of increasing year by year with a significant difference (P <0.05). 312 Candida species included white false silk Saccharomyces cerevisiae accounted for 47.1%, Candida glabrata accounted for 33.7%, Candida tropicalis 13.5%, Candida krusei 3.2%, Candida parapsilosis and Candida albicans 1.3% ; Candida genus mainly from critically ill patients sputum 181 strains accounted for 58.0%, 41 strains of urine accounted for 13.1%, secretions of 27 strains accounted for 8.7%; Candida spp resistant to antibiotics to Itracon The highest azole was 13.6%, followed by voriconazole, fluconazole, flucytosine, resistance to amphotericin B was 0; Candida kirilowii, Candida parapsilosis and Candida glabrata Five antibacterials were resistant to 0. Conclusion Candida infections in critically ill patients show a gradual upward trend, mainly in the respiratory tract, sensitive to amphotericin B and high to itraconazole.