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目的探讨非粒细胞缺乏患者假丝酵母菌属血流感染病原菌分布及临床特征,为临床经验性治疗提供依据。方法回顾性分析2010年12月-2012年12月49例非粒细胞缺乏患者假丝酵母菌属血流感染临床资料,记录每份病历的年龄、基础疾病、中心静脉导管留置时间、抗菌药物应用史、临床表现、病原学、外周血白细胞计数、C-反应蛋白、降钙素原、血清1,3-β-D-葡聚糖及预后情况,采用法国生物梅里埃公司生产的VITEK AMS-60全自动微生物分析仪及YBC酵母菌卡菌种鉴定,用ATBFUNGUS2INT酵母药敏试剂条进行药敏试验,所有数据采用SPSS 13.0统计软件进行处理。结果 49例假丝酵母菌血流感染患者送检标本检出病原菌白色假丝酵母菌20株占40.8%,近平滑假丝酵母菌13株占26.5%,热带假丝酵母菌7株占14.3%;假丝酵母菌血流感染临床特征表现为高热、寒颤、中性粒细胞及C-反应蛋白、降钙素原增高,1,3-B-D葡聚糖检测阳性率42.9%;所有假丝酵母菌对氟康唑均敏感。结论非粒细胞缺乏患者假丝酵母菌血流感染主要病原菌为白色假丝酵母菌及近平滑假丝酵母菌,主要见于导管相关性血流感染;应重视血培养以早期诊断和及时治疗。
Objective To investigate the distribution and clinical features of pathogenic bacteria causing Candida spp in non-granulocytic patients and to provide evidence for clinical experience. Methods Retrospective analysis of 49 cases of non-granulocytic patients with non-granulocytic infection in December 2010-December 2012 clinical data of Candida bloodstream infections, records of each medical history, underlying diseases, catheterization of central venous time, the application of antimicrobial agents History, clinical manifestations, etiology, peripheral blood leukocyte count, C-reactive protein, procalcitonin, serum 1,3-β-D-glucan and the prognosis of the situation, using the French bioMérieux VITEK AMS- 60 automatic microbiological analyzer and YBC yeast strains of bacteria identification, with ATBFUNGUS2INT yeast susceptibility test strips for susceptibility testing, all data using SPSS 13.0 statistical software for processing. Results The results showed that 20 strains of Candida albicans accounted for 40.8%, 13 strains of Candida parahaemolyticus 26.5% and 7 strains of Candida tropicalis 14.3%. The clinical manifestations of Candida infection were high fever, chills, neutrophils and C-reactive protein, increased procalcitonin, and the positive rate of 1,3-BD dextran was 42.9%. All Candida species Sensitive to fluconazole. Conclusions The main pathogens of Candida infection in non-granulocytic patients are Candida albicans and Candida parapsilosis, mainly found in catheter-related bloodstream infections. Early diagnosis and prompt treatment of blood culture should be emphasized.