定植于住院肿瘤患者呼吸道酵母菌的病原学分析_临床医学论文.docVIP

定植于住院肿瘤患者呼吸道酵母菌的病原学分析_临床医学论文 定植于住院肿瘤患者呼吸道酵母菌的病原学分析_临床医学论文 李丁 张文芳 夏睿 郑珊 张青 张鹏 【摘要】 目的分析并探讨肿瘤患者呼吸道定植酵母菌与肿瘤的关系、菌株分布及药敏情况，为临床预防酵母菌感染提供理论依据。方法采用回顾性分析的方法，随机搜集2009年12月—2010年8月从痰液中分离出单一酵母菌(半定量计数gt;105cfu/ml)的本院住院肿瘤患者的病例资料共108例，分析肿瘤与酵母菌定植之间的关系，及108株酵母菌的分布和药敏情况。结果所有酵母菌中白色念珠菌比例最高占63.9%，其次是热带念珠菌，占21.3%。西弗念珠菌的分离率位于第三位。108例患者的肿瘤类型为呼吸系统肿瘤(56例)，消化系统肿瘤(30例)， 其他类型肿瘤(22例)，不同肿瘤类型患者呼吸道中白色念珠菌和热带念珠菌的比例均位于第一及第二位，并且其构成比在不同肿瘤类型患者中无差别(χ2 = 0.216，Pgt;0.05)。共对103株酵母菌进行药敏试验，惟一1株新生隐球菌对所有抗真菌药均不敏感;念珠菌中除克柔念珠菌、光滑念珠菌外，其余念珠菌对唑类和两性霉素B均敏感，但对氟康唑敏感的念珠菌中有8株的MIC值范围在4～8μg/ml，念珠菌对氟胞嘧啶的敏感性为95.1%，不如上述三种药物。结论侵袭性酵母菌感染的预防性治疗可以首选唑类药物，但应定期监测药敏，积极与临床微生物室交流，及时调整用药改善患者预后。 【关键词】 真菌;呼吸道;肿瘤患者 　　[Abstract]ObjectiveTo investigate the clinical distribution and drug-susceptibility characteristics of yeast species in tumor patients with respiratory tract yeast colonization and provide the gist for clinical prophylaxis.MethodsThe medical records of 108 tumor patients were randomly collected from patients whose respiratory tract only had one kind of yeast colonization, retrospectively analyzed the relationship between different tumor types and yeast colonization.Meanwhile,analyzed the clinical distribution and drug-susceptibility characteristics of 108 strains yeast.ResultsThe first species of yeast causing colonization was Candida albicans(69 strains in total,48.6%),the second was Candida tropicalis(23 in total,21.3%),then was Candida ciferrii(7 in total 6.5%).All of the types of tumor were classified into three categories,which were respiratory tract tumor(56 cases), digestive system tumor(30 cases) and other tumor(22 cases).In different kinds of tumors,the first and second kind of yeast were aways Candida albicans and Candida tropicalis,and the percentages of the two Candida in the three kinds of tumors were no significant difference(χ2 = 0.216，Pgt;0.05).In this study, 102 strains Candida and 1 strain Cryptococcus neoformans were performed antifungal drug sensitive test. Cryptococcus neoformans was unsusceptibility to all of