摘要
目的 了解深部真菌医院感染的临床状况、病原菌分类、危险因素及耐药现状。方法 对186例深部真菌医院感染的病案进行了资料统计,并按卫生部《医院感染诊断标准》进行分析。结果 深部真菌感染率为7.8％,其中以白色假丝酵母菌为主,占53.2％,热带假丝酵母菌次之,为12.9％;医院感染危险因素为严重的相关基础疾病、年龄老龄化、住院日长、皮质激素和免疫抑制剂的应用,各种侵入性诊疗技术及广谱抗生素的大量使用等;深部真菌对两性霉素B（AMB）、氟康唑（FCZ）、制霉菌素（NYS）与5-氟胞嘧啶（5-FC）的敏感率均较高,分别为98.9％、96.7％、96.7％和91.4％;但对酮康唑（KET）耐药率已达31.7％,咪康唑（MIZ）、益康唑（ECO）耐药率和中介率均达10％或以上。结论 深部真菌医院感染及耐药性呈上升趋势,特别是唑类抗真菌药已呈明显耐药,采用有效的防治措施刻不容缓。
OBJECTIVE To investigate clinic status, distribution of pathogens, risk factors and current status of resistant hospital acquired infection of deep fungus. METHODS One hundred and eight six cases of hospital acquired infection of deep fungus, were analyzed in accordance with 《Diagnosis standard of hospital acquired infection》. RESULTS Hospital acquired infection rate was 7. 8%. The most of the organism was Candida albicans (53. 2%), the second one was C. tropicalis (12. 9%). Many factors including correlated serious original diseases, aging, long course of hospitalization, application of adrenocortical steroid and immunosuppressant, diverse aggressive techniques of diagnosis and treatment and plentiful use of antibiotics etc, were the risk factors resulted in hospital infection. Deep fungus had higher sensitivity to amphotericin B(AMB), fluconazole (FCZ), nystatin (NYS) and flucytosine (5-FC), their rates of sensitivity were 98. 9% , 96. 7% , 96. 1% and 91.4%, respectively. The resistance rate of ketoconazole (KET) had reached 31. 7%,the resistance rates had all reached 10% or more in both miconazole (MIZ) and econazole (ECO). CONCLUSIONS Hospital acquired infection of deep fungus and resistance had an increasing tendency, evident resistance had been found in some antifungal drugs,especially azoles. So it is the time to take some effective control means.
出处
《中华医院感染学杂志》
CAS
CSCD
2002年第7期485-487,共3页
Chinese Journal of Nosocomiology
关键词
深部真菌
医院感染
抗真菌药物
多药耐药性
危险因素
Deep fungus
Hospital acquired infection
Antifungal drugs
Multiple drug resistance
