摘要
目的:探讨真菌性泌尿系感染的菌群分布和药敏情况,从而指导临床合理使用抗真菌药物。方法:回顾性分析2010年1月~2016年12月广州医科大学附属第一医院泌尿外科确诊的真菌性泌尿系感染患者的中段尿培养阳性结果(菌株鉴定和药敏试验)及临床资料。结果:从3 473份中段尿培养阳性标本中共分离出真菌224株,分离率为6.45%,其中男111例,女113例,年龄16~90岁,平均(54.84±15.08)岁。最常见的真菌为白假丝酵母菌,共111株(49.55%),其次为光滑假丝酵母菌53株(23.66%)。两性霉素B和氟康唑对所有菌株敏感率较强,两性霉素B与氟康唑的敏感率均分别高于伊曲康唑、咪康唑和5-氟胞嘧啶,差异均有统计学意义(P<0.05)。结论:真菌性泌尿系感染以白假丝酵母菌为主。临床上经验性治疗可首选氟康唑,严重感染患者考虑两性霉素B治疗,并及时根据菌株的鉴定结果及其药敏试验有效地调整治疗方案。
Objective：To investigate fungus spectrum and antibiotic susceptibility analysis of fungal urinary tract infection patients in order to guide the rational use of antifungal drugs.Method：We retrospectively analyzed middle positive urine culture results（strain identification and antibiotic susceptibility analysis）and clinical data of diagnosed fungal urinary tract infection patients from January 2010 to December 2016 in First Affiliated Hospital of Guangzhou Medical University.Result：A total of 224 fungus（6.45%）were isolated from 3473 middle positive urine culture samples,including 111 males and 113 females whose average age was 54.84±15.08（range,16-90）years old.The most common fungus is Candida albicans（111,49.55%）,followed by Candida glabrata（53,23.66%）.All the bacterial strains were more sensitive to amphotericin B and fluconazole,which susceptibilities were higher than itraconazole,miconazole and 5-fluorocytosine（P〈0.05）.Conclusion：Fungal urinary tract infection is mainly caused by Candida albicans.Fluconazole is the first choice for clinical experimental treatment,amphotericin B may be used for severe infection,and treatment program should be adjusted according to the results of strain identification and antibiotic susceptibility analysis.
作者
钟芳灵
张玉艳
梁雄发
黄健
陈东
雷鸣
曾国华
吴文起
ZHONG Fangling;ZHANG Yuyan;LIANG Xiongfa;HUANG Jian;CHEN Dong;LEI Ming;ZENG Guohua;WU Wenqi(Department of Urology, First Affiliated Hospital of Guangzhou Medical University, Guang- dong Key Laboratory of Urology, Guangzhou, 510230, China;Department of Pharmacy, Guangzhou Institute of Dermatology)
出处
《临床泌尿外科杂志》
2018年第5期390-392,397,共4页
Journal of Clinical Urology
基金
国家自然科学基金(编号81570633)
广州市科技局项目(编号201604020001)
广州市教育局协同创新重大项目(编号1201620011)
关键词
真菌性泌尿系感染
菌群分布
药敏分析
fungal urinary tract infection
fungus spectrum
antibiotic susceptibility analysis
