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目的探讨2型糖尿病患者真菌性泌尿系感染的真菌菌群分布及耐药性。方法回顾性分析在台州市恩泽医疗中心(集团)路桥医院就诊的1 000例2型糖尿病患者,所有患者均送检清洁中段尿进行检查,对判断为真菌性泌尿系感染患者的尿液进行真菌培养,观察菌群分布及耐药性。结果 2型糖尿病患者泌尿系真菌感染率达8.70%,共培养出103株真菌,其中排名前六的真菌分别是白假丝酵母菌、光滑假丝酵母菌、热带假丝酵母菌、克柔假丝酵母菌、法氏假丝酵母菌和近平滑假丝酵母菌;对主要致病菌耐药性较低的药物是5-氟胞嘧啶(2.91%)和两性霉素B(0.97%)。两性霉素B和5-氟胞嘧啶的耐药率均明显低于氟康唑、伊曲康唑与伏立康唑(χ~2=21.58、31.93;17.94、16.43;26.30、13.03,P<0.01)。结论 2型糖尿病患者真菌性泌尿系感染的发生率较高,以白假丝酵母菌、光滑假丝酵母菌和热带假丝酵母菌最为多见,临床医师应根据病原学、耐药性检查及安全性选择合适的抗生素,对无法进行耐药性检查的患者可首选两性霉素B。
Objective To investigate the fungal flora distribution and drug resistance of fungal urinary tract infection in type 2 diabetic patients. Methods A retrospective analysis of 1,000 cases of type 2 diabetes patients treated at Luqiao Hospital of Enze Medical Center (Group) in Taizhou City was performed. All patients were examined for mid-clean urine and fungi were determined for the urine of patients with fungal urinary tract infection Cultivation, observation of flora distribution and drug resistance. Results Urinary tract fungal infection rate was 8.70% in type 2 diabetic patients and 103 strains were co-cultivated. The top six fungi were Candida albicans, Candida glabrata, Candida tropicalis, Candida albicans and Candida parapsilosis; 5-fluorocytosine (2.91%) and amphotericin B (0.97%) were less resistant to the major pathogens. Amphotericin B and 5-fluorocytosine resistance rates were significantly lower than fluconazole, itraconazole and voriconazole (χ ~ 2 = 21.58,31.93; 17.94,16.43; 26.30,13.03, P <0.01). Conclusion The incidence of fungal urinary tract infection in patients with type 2 diabetes is high, with Candida albicans, Candida glabrata and Candida tropicalis the most common, clinicians should be based on etiology, drug resistance test and Select the appropriate safety of antibiotics, can not be the first choice for amphotericin B in patients with resistance tests.