目的 分析医院内感染假丝酵母菌菌种构成和耐药性。 方法 对临床标本分离的酵母样真菌,用VITEK-Ⅱ(生物梅里埃公司)生化鉴定仪、API20c生化鉴定试纸条和念珠菌显色琼脂以及聚合酶链反应(polymerase chain reaction, PCR)方法进行酵母样真菌菌种的鉴定,应用ATB Fungus3 进行药敏试验。 结果 96株酵母样真菌,可分为6个种,包括白色念珠菌40株 (41.7%)、热带念珠菌36株 (37.5%)、光滑念珠菌13株 (13.54%)、近平滑念珠菌5株 (5.21%)、克柔念珠菌1株 (1.04%)、挪威念珠菌 1株(1.04%)。各种假丝酵母菌对5种抗真菌药呈现不同的敏感性,对两性霉素B和5-氟胞嘧啶的敏感率为100%,而对氟康唑、伊曲康唑、伏立康唑则表现出一定的耐药性。 结论 基因间隔转录区分子生物学分析结合传统培养和生化方法,可有效提高假丝酵母菌鉴定的准确性。本研究结果提示医院内非白假丝酵母菌感染有增多趋势。重症监护病房(intensive care unit, ICU)是重要的假丝酵母菌来源科室。60岁以上的老龄患者是医院内真菌感染的高危人群。体外药敏试验提示部分假丝酵母菌出现了唑类药物(氟康唑和伊曲康唑)的耐药性。
Objective To identify species composition of Candida clinical isolates and analyze the antibiotic resistance of the isolates. Methods VITEK Ⅱ, API20c, CHRO Magar and PCR method were used to identify yeast like clinical isolates, and the ATB Fungus3 was used for antibiotic resistance testing. Results A total of 96 yeast like clinical isolates from China Japan Friendship Hospital were identified, which belonged to 6 species, including 40 Candida albicans strains (41.7%), 36 Candida tropicalis strains (37.5%), 13 Candida glabrata strains (13.54%), 5 Candida parapsilosis strains (5.21%), 1 Candida krusei strain (1.04%) and 1 Candida Norway strain (1.04%). The strains showed different drug susceptibility to 5 anti fungal drugs tested. The strains were 100% sensitive to 5 flucytosine and amphotericin b, but showed different resistance to 3 azoles, including fluconazole, itraconazole and voriconazole. Conclusion Molecular analysis of the ITS region combined with traditional culturing is a effective way for the identification of Candida. In this study, the results indicated that infection of non albicans Candida was in increase. ICU is the place where Candida is frequently isolated. Patients aged >60 years are at high risk of the nosocomial infection. The results of anti fungi test in vitro showed that some Candida isolates had resistance to azole antifungal drugs.