【摘要】 目的了解自身免疫病(AD)患者真菌感染的病原菌种类及耐药状况,为真菌感染的防治提供依据。方法应用ATB Expression自动细菌鉴定系统对临床标本中分离的病原菌进行鉴定,药敏试验应用ATB HUNGUS药敏试条上机测试。结果 428例AD患者并发真菌感染36 例,感染率为8．4％。感染部位主要为下呼吸道(53．5％)、泌尿道(20．9％)、肠道(11．6％)等。共分离出43株真菌,其中白念珠菌28株(65．1％),光滑念珠菌5株(11．6％),热带念珠菌3株 (7．0％),近平滑念珠菌2株(4．7％),曲霉菌2株(4．7％),其他真菌3株(7．0％)。药敏结果显示: 白念珠菌对酮康唑、咪康唑及益康唑的耐药率较高,分别为35．7％、46．4％及32．1％,而对氟康唑、两性霉素B、制霉菌素及氟胞嘧啶的耐药率则较低,分别为0、14．3％、14．3％及7．1％,其他真菌的耐药性与白念珠菌相似。结论AD患者并发真菌感染以白念珠菌为主。应尽早在药敏试验结果指导下进行抗真菌治疗并加强综合支持治疗。更多还原

【Abstract】 Objective To identify the most common fungal pathogens and their antifungal drug resistance in autoimmune disease (AD) patients with fungal infection , for guiding the rational use of antifungal therapy. Methods The identification were analyzed by ATB Expression automatic microbiology analytical instrument system. The antifungal susceptibility test was done by ATB FUNGUS strip. Results Of 428 patients studied,36(8.4%) had fungal infections. The most commonly infective sites were lower respiratory tract(53.5%),urinary tract(20.9%), intestinal tract(11.6%). A total of 43 fungi strains were isolated, the most common fungi were Candida albicans (65.1%), Candida glabrata (11.6%), Candida tropicalis (7.0%),and Candida parapsilosis (4.7%).Resistance rates of Candida albicans against ketoconazole, miconazole and econazole were 35. 7% , 46.4% and 32.1% , while resistance rates to fluconazole, amphotericin B, nystain and flucytosine were much lower, being 0, 14.3% , 14.3% and 7.1% . The resistance rates of other fungi were similar to Candida albicans. Conclusion The main pathogens causing fungal infection in patients with AD is Candida albicans. It should as early as possible process the clinical antifungal therapy under the result of antifungal susceptibility test and supportive measure.更多还原