念珠菌感染特性及耐药性分析 医学检验大学本科毕业论文.docVIP

念珠菌感染特性及耐药性分析 摘 要 目的 探讨念珠菌感染的特点及耐药性情况，为临床合理选用抗真菌药物提供实验室依据。 方法 应用回顾性调查分折的方法，对我院1年间住院病人、门诊病人标本分离的193株念珠菌进行统计并对常用抗真菌药敏试验结果进行分折。 结果 分离出的念珠菌以内科系统为主，共分离出136株(占70.47%)；检出真菌最多的部位是呼吸道，占真菌标本的76.17%；其种类以白色念珠菌及热带念珠菌为主，分别占73.58%和15.54%；药敏结果中：两性霉素B、制霉菌素均有90%以上的敏感率，特比萘芬对白色念珠菌的敏感率仅6.3%，但对热带念珠菌的敏感率为100%。 结论 加强临床真菌分离菌株对抗菌药物的耐药性关注，根据药敏试验合理应用抗真菌药物十分重要。 关健词：念珠菌,感染特性, 耐药性 ABSTRACT objective To investigate the characteristic of Candida infection and examine the drug resistance condition, so as to provide assistance to the reasonable use of antifungal agents clinically. Methods To analyze the status of drug resistance of 193 strains of Candida, which were isolated from inpatients and outpatients of our hospital. Antifungal agents susceptibility test was done to know the drug resistance. Results The Candida isolated in our hospital were predominant from medical unit, 136 strains of Candida were identified(accounted for 70.47%); The specimens where detected Candida were mostly from respiratory tract, accounting for 76.17%. The Strains of Candida albicans and C. tropicalis had the highst detection rates, accounting for 73.58% and 15.54% respectively. The rates of susceptibility of Candida to Amphotericin B, Nystatin were more than 90%, and the rates of susceptibility to Terbinafine was only 6.3% for Candida albicans, but 100% for C. tropicalis. Conclusion Pay more attention to the drug resistance to the Candida isolated from the clinical. Antifungal agents should be selected reasonably according to the result of drug susceptibility test. KEY WORDS ：Candida，infection characteristic，Drug resistance 目 录 绪论1.1 念珠菌简介 1.2 念珠菌致病机理 1.3 念珠菌影响因素 1.4 念珠菌相关感染 念珠菌感染特性及耐药性分析 2.1 材料与方法 2.2 结果 2.3 讨论 参考文献第章 真菌感染已成为白血病，淋巴瘤，免疫抑制，长期使用广谱抗生素，中心静脉插管，中性粒细胞减少，烧伤，低体重的早产儿，血液透析，骨髓或器官移植，胃肠道手术和机械通气等特殊人群的严重感染性疾病。氟康唑可接受的抑菌环直径范围为28-39mm1.2.1 细菌分离鉴定按《全国临床检验操作规程》[3]进行培养分离，分离所得念珠菌采用chromG A显色培养基或用VITEK-32 YBC卡鉴定到种的水平。1.2.2 细菌药敏试验 采用2003年美国国家临床试验标准化委员会(NCCLS)认可的酵母菌纸片扩散法进行敏感性试验。Mueller-Hinton(MH)