CAJ | 학술논문

目的：分析肝病患者真菌感染的特点和耐药性，为临床预防真菌感染和合理用药提供依据。方法回顾分析2011年1月-2014年6月临床分离的1472株真菌的组成及耐药性。结果肝病患者真菌感染的主要标本来源是痰、中段尿和腹水。菌种以白假丝酵母菌为主（54.96%），其次是烟曲霉菌（13.25%），热带假丝酵母菌和光滑假丝酵母菌分别为10.39%和10.26%。丝状真菌对抗真菌药的耐药率明显高于酵母菌（P=0.000）。对氟康唑的耐药率较高的为烟曲霉菌（100%）、克柔假丝酵母菌（81.67%）和光滑假丝酵母菌（24.50%），克柔假丝酵母菌对伊曲康唑的耐药率达16.67%，白假丝酵母菌的药物敏感性较好。结论肝病患者真菌感染以白假丝酵母菌为主，其次是烟曲霉菌。不同种的真菌对不同抗真菌药的敏感性不同，临床应根据患者真菌感染和耐药特点合理治疗。
목적：분석간병환자진균감염적특점화내약성，위림상예방진균감염화합리용약제공의거。방법회고분석2011년1월-2014년6월림상분리적1472주진균적조성급내약성。결과간병환자진균감염적주요표본래원시담、중단뇨화복수。균충이백가사효모균위주（54.96%），기차시연곡매균（13.25%），열대가사효모균화광활가사효모균분별위10.39%화10.26%。사상진균대항진균약적내약솔명현고우효모균（P=0.000）。대불강서적내약솔교고적위연곡매균（100%）、극유가사효모균（81.67%）화광활가사효모균（24.50%），극유가사효모균대이곡강서적내약솔체16.67%，백가사효모균적약물민감성교호。결론간병환자진균감염이백가사효모균위주，기차시연곡매균。불동충적진균대불동항진균약적민감성불동，림상응근거환자진균감염화내약특점합리치료。
Objective To analyze the characteristics and drug resistance of fungal infections in patients with liver disease, and to provide the basis for rational drug use and prevention of fungal infections in clinical practice. Methods The composition and resistance of 1472 fungal specimens from January 2011 to June 2014 were analyzed retrospectively. Results The mainly sources of fungal infections in patients with liver disease were from sputum, ascites and urine specimens. Candida albicans strains accounted for 54.96%, Aspergillus fumigatus 13.25%, Candida tropicalis 10.39% and Candida glabrata 10.26%. The resistant rate to antifungal agents of fungus was higher than that of yeast (P=0.000). The higher resistant rate to fluconazole happened to Aspergillus fumigatus(100%), Candida krusei (81.67%) and Candida glabrata (24.50%), and 16.67% Candida krusei happened to itraconazole. To comparison, the better sensitivity to antifungal agents was Candida albicans. Conclusion The main fungal infection in patients with liver disease is Candida albicans, and then Aspergillus fumigatus. Different fungus have the different sensitivities to antifungal agents, The design of theatment should based on clinical and resistant features of fungal infection in patients with liver disease.