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目的了解ICU患者感染念珠菌的临床分布特点及药物敏感性,以指导临床合理使用抗真菌药物减少侵袭性真菌病(IFD)的发生,降低其病死率。方法对2013年1月-2014年12月ICU患者送检5 892份标本中分离出346株念珠菌进行回顾性分析,念珠菌用CHROMagar显色培养基鉴定,疑难菌株用API 20C AUX鉴定板鉴定,采用ATB FUNGUS 3药敏板进行药敏检测。结果从ICU送检的各类标本中分离出念珠菌346株,以白色念珠菌的检出率居首位,检出204株占59.0%,其余为近平滑念珠菌47株占13.6%、热带念珠菌40株占11.6%等;药敏结果显示,5-氟胞嘧啶、两性霉素B对念珠菌属的敏感率高,但唑类药物敏感率在不同种的念珠菌中的体外药敏试验结果有一定的差异。结论必须重视念珠菌的培养鉴定和体外药敏数据分析,合理选用抗真菌药。
Objective To investigate the clinical distribution and drug sensitivity of candida in ICU patients so as to guide clinical rational use of antifungal drugs to reduce the occurrence of invasive fungal disease (IFD) and reduce its mortality. Methods A total of 346 Candida isolates were isolated from 5 892 specimens of ICU patients from January 2013 to December 2014. Retrospective analysis was performed on Candida albicans using CHROMagar chromogenic medium and API 20C AUX identification plates , Using ATB FUNGUS 3 susceptibility plate for susceptibility testing. Results There were 346 strains of Candida isolated from all kinds of specimens tested by ICU. Candida albicans was the most frequently detected, with 204 strains accounting for 59.0% and 47 strains accounting for 13.6% of Candida parapsilosis, tropical 40 strains of Candida accounted for 11.6%, etc .; drug susceptibility results showed that 5-fluorocytosine, amphotericin B on Candida sensitivity, but susceptibility to azole drugs in different Candida species in vitro susceptibility Test results have some differences. Conclusion It is necessary to pay attention to the culture identification of Candida and in vitro susceptibility data analysis, the rational use of antifungal agents.