【摘要】 目的　对我院 83例院内肺部真菌感染的病历进行临床资料、病原学分布、危险因素及耐药现状的调查分析 ,旨在引起临床医师对真菌感染领域的高度重视。方法　将留取的合格痰液经培养、鉴定分离出真菌 98株 ,使用微量稀释法测定最低抑菌浓度 ,药物包括氟康唑、酮康唑、咪康唑、5 氟胞嘧啶、伊曲康唑、两性霉素B ,对计数资料进行统计描述分析。结果　 83例患者均患有肺部疾病 ,其中以慢性阻塞性肺病、慢性肺源性心脏病导致的真菌感染最多 ,共占 6 8% ;住院日的延长、广谱、多种抗生素的应用以及医源性因素易导致真菌感染 (与对照组比较P <0 .0 1) ;在分离的真菌中 ,以类酵母菌为主 ,仅念珠菌属即占 90 % ,特别是白色念珠菌 (占 71% ) ,其他真菌分离率均小于 10 % ;98株真菌对 6种抗真菌药物敏感试验结果提示 5 氟胞嘧啶有 90 %的敏感率 ,可作为抗真菌感染的常用药物。咪康唑、伊曲康唑对真菌已分别有 2 3.4 %、2 7.1%的耐药率。结论　PFIH及耐药性呈上升趋势 ,减少或避免可能导致真菌感染的各种因素 ,并采取有效的防治措施刻不容缓更多还原

【Abstract】 Objective To investigate clinic status, distribution of pathogens, risk factors and current status of drug resistant of 83 cases confirmed of pulmonary fungal infection in hospital (PFIH), and arouse doctors to pay attention to the field of fungus infections. Methods 98 fungal pathogens were isolated after being identified from sputum. Simultaneously to micro inhibition concentration was determined by microdilute analysis. Results 83 patients with fungal infections almost occurred among chronic obstructive pulmonary disease (COPD) and chronic pulmonary heart disease, both accounting for 68%; factors including long course of hospitalization, plentiful use of antibiotics and diverse aggressive techniques of diagnosis and treatment etc, were the risk factors resulted in PFIH (vs control group, P< 0.01 ); The species distribution showed the most commonly identified species were Candida albicans(71%), followed by other fungus. They had higher sensitivity to flucytosine, the rate of sensitivity was 90%; The resistance rate of miconazole and itraconazole had reached 23.4 %, 27.1 %. Conclusions PFIH and resistance had an increasing tendency. So it is time to reduce and avoid the risk factors and to take some effective control means.更多还原