摘要
目的探讨尿路念珠菌感染的病原菌流行病学特征及分析氟康唑治疗尿路念珠菌感染的疗效。方法采用单中心、回顾性研究方法,收集62例氟康唑治疗尿路念珠菌感染患者的临床资料。结果本研究中,白念珠菌、光滑念珠菌和热带念珠菌感染所占比例分别为32.3%、30.6%和30.6%。其他感染病原菌包括2株近平滑念珠菌和2株链状假丝酵母菌。念珠菌对氟康唑的最低抑菌浓度(MIC)在1~128μg/mL范围内均有分布,对氟康唑的耐药率为17.7%(11/62)。氟康唑治疗尿路念珠菌感染总体有效率为54.8%(34/62),200与400mg/d两种给药方案的治疗有效率分别为53.1%和56.7%。Logistics回归模型表明氟康唑治疗尿路念珠菌感染与日剂量和MIC比值(Dose/MIC)具有显著相关性(P=0.006,OR=1.006)。当Dose/MIC>200时,临床有效率可达73.3%。结论尿路念珠菌对氟康唑的耐药率高,非白念珠在尿路感染中比例增加,氟康唑治疗尿路念珠菌感染的疗效与Dose/MIC值具有显著相关性。临床实践中应结合药敏结果制定尿路念珠菌感染的抗真菌给药方案。
Objectives To investigate the epidemiological characteristics of Candida urinary tract infections(UTIs)and to analyze the efficacy of fluconazole in the treatment of Candida UTIs.Methods This was a single center and retrospective study,and 62 patients with Candida UTIs treated with fluconazole were included in the present study.Results In this study,32.3%,30.6%,and 30.6%of patients were infected by Candida albicans,Candida glabrata,and Candida tropicalis,respectively.Other pathogens included two strains of Candida parapsilosis and two strains of Candida catenulata.The minimum inhibitory concentration(MIC)of Candida spp.to fluconazole was distributed in the range of 1 to 128μg/mL,and 17.7%of Candida were resistant to fluconazole.The overall effective rate of fluconazole in the treatment of Candida UTIs was 54.8%(34/62).The efficacy of dosage regimen of 200 and 400mg/d was 53.1%and 56.7%,respectively.The Logistics regression model showed a significant correlation between the efficacy and the ratio of fluconazole daily dose to MIC(Dose/MIC)(P=0.006,OR=1.006).When Dose/MIC values were more than 200,the clinical effective rate of fluconazole treatment could reach 73.3%.Conclusion The Candida spp.in UTIs had a high rate of resistance to fluconazole,and the proportion of non-Candida albicans in UTIs was increased.For the treatment of Candida UTIs,the Dose/MIC values had a significant correlation with the efficacy of fluconazole treatment.In clinical practice,the appropriate antifungal regimens used to treat Candida UTIs should be chosen based on susceptibility results.
作者
王兴刚
王陶陶
王茂义
马瑛
Wang Xing-gang;Wang Tao-tao;Wang Mao-yi;Ma Ying(Department of Pharmacy,Pulmonary Hospital of Lanzhou,Lanzhou 730046;Department of Pharmacy,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061)
出处
《中国抗生素杂志》
CAS
CSCD
2019年第10期1209-1213,共5页
Chinese Journal of Antibiotics
基金
陕西省自然科学基础研究计划项目(No.2014JM4101)
关键词
氟康唑
流行病学
尿路念珠菌感染
最低抑菌浓度
Fluconazole
Epidemiology
Candida urinary tract infections
Minimal inhibitory concentration
