《如何看待非白念 .pptVIP

氟康唑敏感性变化(2010-2011) 3.1% Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 伏立康唑敏感性变化(2010-2011) 0.3% Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 念珠菌属耐药情况 总体上对氟康唑敏感性仍高 在分离率前5位的酵母样真菌中，仅光滑念珠菌对氟康唑、伏立康唑的敏感性较低并存在交叉耐药；其他常见酵母菌氟康唑敏感率均92%，伏立康唑敏感率97% 氟康唑对近平滑耐药率较低 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 念珠菌药敏试验 对白念珠菌不推荐常规进行药敏试验，因耐药菌株少见。 对从血流或其他无菌部位分离的光滑念珠菌和怀疑对唑类药物耐药的其他非白念珠菌可进行药敏测定 对抗真菌治疗无效或需要长期应用抗真菌治疗的病例亦应进行药敏测定以排除耐药菌株的可能 中国2011《念珠菌病诊断与治疗：专家共识》 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 侵袭性念珠菌病的危险因素 全身应用糖皮质激素 接受广谱抗菌药治疗 使用中央静脉导管 全胃肠外营养 胃肠道或心脏外科手术 住院时间延长 人住ICU 念珠菌定植 烧伤 早产 中性粒细胞减少 HIV感染 糖尿病 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 继发性肺念珠菌病（念珠菌血流感染） 按三级诊断 确诊 肺部浸润 呼吸道分泌物≥2次或支气管肺泡灌洗液≥1次分离到与血液标本所分离菌株相同的念珠菌 血培养证明的念珠菌血症 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 继发性肺念珠菌病（念珠菌血流感染） 按三级诊断 临床诊断 宿主危险因素 临床具有念珠菌血症或严重脓毒血症表现，肺内浸润性病变抗生素治疗无效 血清G试验阳性或呼吸道标本1次检测到念珠菌且涂片见到大量菌丝 拟诊 宿主因素+临床表现 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 警惕念珠菌血症是关键 危险因素+念珠菌检测 血液和静脉导管培养 眼底检查 CT牛眼征 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 原发性肺念珠菌病 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 2004-2011 Aspose Pty Ltd. 宿主因素不同于播散型念珠菌病经典的危险因素 意识障碍 头颈部肿瘤接受化放疗者（口咽部易有念珠菌重度定植和吸入） 危重患者 机械通气治疗等 原发性肺念珠菌病 Evaluation only. Created with Aspose.Slides for .NET 3.5 Client Profile 5.2.0.0. Copyright 200