从卫生保健相关感染病例中分离的丝状真菌的鉴定和抗真菌敏感性分析

Kamaljeet, Naveen R. Saxena, Mohit Thalquotra
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摘要

虽然,细菌被认为是医疗保健相关感染(HCAI)的最常见原因,但近年来,真菌病原体的分离越来越多。从HCAI病例中分离出的真菌病原体主要为种、毛霉菌、spp、spp和spp。与细菌性医院感染相比,真菌感染通常难以诊断和治疗。医院真菌病与高死亡率和发病率有关。本研究在三级专科医院进行,目的是鉴定从HCAI中分离的丝状真菌病原体并研究其抗真菌药敏谱。包括从重症监护病房(MICU) HCAI病例中分离的丝状真菌。采用标准真菌学技术对其进行鉴定,并进行抗真菌敏感性分析。50例真菌病原菌中,21例(42%)分离到spp, 29例(58%)分离到丝状真菌。丝状真菌病原菌以51.7%占主导地位。(27.6%)为优势分离株。使用广谱抗生素后出现中性粒细胞减少和留置医疗器械是丝状真菌引起的HCAI的常见危险因素。对两性霉素B耐药的占6.9%,对氟康唑耐药的占33.3%。侵袭性真菌感染(IFI)虽然不常见,但与ICU住院患者的发病率和死亡率增加有关。中性粒细胞减少和广谱抗生素的使用是IFI的重要危险因素。是IFI最常见的丝状真菌病因。应更加强调快速诊断、及时治疗和严格遵守感染预防和控制做法。
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Identification and antifungal susceptibility profile of filamentous fungi isolated from cases of healthcare associated infections
Although, bacteria have been considered as most common cause of healthcare associated infections (HCAI), however recent years have witnessed increased isolation of fungal pathogens. species, Mucorales, spp., spp. and spp. are predominant fungal pathogens isolated from cases of HCAI. As compared to bacterial nosocomial infections, fungal infections are generally difficult to diagnose and treat. Nosocomial mycoses are associated with high mortality and morbidity. The present study was conducted in the tertiary care academic hospital with an aim to identify filamentous fungal pathogen isolated from HCAI and study its antifungal susceptibility profile. Filamentous fungi isolated from cases of HCAI from intensive care unit (MICU) were included. They were identified by standard mycological techniques and antifungal susceptibility profile was studied. Out of 50 fungal pathogens, spp. were isolated from 21 (42%) cases, whereas 29 (58%) isolates were filamentous fungi. spp. (51.7%) were predominant among filamentous fungal pathogen. (27.6%) was the predominant isolate. Use of broad-spectrum antibiotics followed by neutropenia and presence of indwelling medical devices were common risk factors associated with HCAI due to filamentous fungi. Amphotericin B resistance was observed in 6.9% of isolates whereas 33.3% were resistant to fluconazole. Invasive fungal infection (IFI) though less common is associated with increased morbidity and mortality in patients admitted to ICU. Neutropenia and use of broad spectrum antibiotics are important risk factors for IFI. is the most common filamentous fungus cause of IFI. More emphasis should be given on rapid diagnosis, prompt treatment and strict compliance with infection prevention and control practices.
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