Distribution characteristics and drug sensitivity analysis of clinical fungi isolated from elderly inpatients
Objective To explore the distribution characteristics and drug resistance characteristics of fungal strains clin-ically isolated from elderly inpatients,and provide reference for the prevention,control,diagnosis andtreatment of fungal infec-tions in elderly patients.Methods The clinical samples,gender,age and other clinical information of inpatients who were≥60 years old and positive for fungal culture in a Grade Ⅲ and first-class hospital in Shanghai were collected from January to De-cember 2022.Candida screening medium was used for isolation and culture,and the strains were identified by MALDI-TOF MS.ATB FUNGUS 3 was used for in vitro drug susceptibility testing of amphotericin B(AMB),fluconazole(FCA),itra-conazole(ITR),voriconazole(VRC)and5-fluorocytosine(5FC).Results Among inpatients aged60-104,1 632 strains of fungi were isolated.with more males(997/1 632,61.09% )than females.The patients aged 70-79 had the most strains(569/1 632,34.87% ),andthefungi isolated from ICU was the most(720/1632,44.12% ).The top4 strains isolated were all Candida(1 596/1 632,96.38% ),with the highest detection rate of Candidaalbicans(906/1 632,55.51% ),followed by Candida glabrata(350/1 632,21.45% ),Candida tropicalis(194/1 632,11.89% ),and Candida parapsilosis(123/1 632,7.54% ).The resistance rate of main Candida to AMB and5FC ranged from0 to2.86% .The resistance rate of Candida albi-cans to the other three azole drugs was lower than 15% .The resistance rate of Candida glabrata to ITR was 42.86% .The re-sistance rate of Candida tropicalis to ITR was the highest(61.34% ),and the resistance rate to VRC and5FC were more than 50% .The four main types of Candida were mostly isolated from male patients,and there was no statistically significant differ-ence in drug resistance rates between different genders(P＞0.05).In addition,247 Candida strains were completely resistant to3 kinds of azole drugs,and the detection rate of Candida tropicalis was the highest(99/194,51.03% ).Conclusion ICU should pay more attention to the occurrence and prevention of nosocomial fungal infection in elderly inpatients.Candida albi-cans is still the main isolated species,but the increased detection rate of Candida glabrata and Candida tropicalis and the high resistance rate to azole drugs should also attract clinical attention.Regular surveillance on fungal susceptibility is still a necessa-ry measure.
国家科技期刊平台
NSTL
万方数据
维普
