Department of Medicine, National Cheng Kung University Medical College, Tainan, Taiwan.
Mycoses. 2011 Jul;54(4):e17-23. doi: 10.1111/j.1439-0507.2009.01818.x. Epub 2009 Dec 17.
The aim of this study was to evaluate the incidence of candidaemia, consumption of fluconazole and susceptibility of blood Candida isolates at a tertiary hospital. From January 1999 to September 2006, all candidaemic episodes were identified and available strains were evaluated for the susceptibilities of antifungal agents. Annual defined daily doses of antifungal agents were collected. There had been 909 Candida isolates detected from the bloodstream of 843 patients during the study period. Among them, 740 isolates were available for the susceptibilities of antifungal agents. The incidence density of candidaemia was 28 episodes per 10,000 patient-days. Species distribution of 909 isolates did not vary annually, but varied greatly in the units of the hospital. Candida parapsilosis was the more prominent (30.1%) isolate in the paediatric units, where C. tropicalis and C. glabrata were less common (12.3% and 1.4% respectively). Resistance rates for itraconazole, fluconazole and voriconazole were 6.9%, 3.8% and 3.8% respectively. There were 25 (3.4%) isolates resistant to amphotericin-B. Although fluconazole usage increased over time (r(2) = 0.45; P = 0.07), fluconazole resistance did not increase accordingly (P = 0.33). In our institution in which the incidence of candidaemia was high, fluconazole resistance among blood Candida isolates remained rare.
本研究旨在评估一家三级医院的念珠菌血症发生率、氟康唑的使用情况以及血源念珠菌分离株的药敏情况。1999 年 1 月至 2006 年 9 月，所有念珠菌血症病例均被确定，并对可用菌株进行了抗真菌药物药敏评估。收集了每年抗真菌药物的限定日剂量。在研究期间，从 843 例患者的血液中检测到 909 株念珠菌。其中，740 株可用于评估抗真菌药物的药敏情况。念珠菌血症的发生率密度为每 10000 个患者日 28 例。909 株分离株的种属分布每年无变化，但在医院的不同科室之间差异很大。在儿科病房，近平滑念珠菌是更为突出的（30.1%）分离株，热带念珠菌和光滑念珠菌则较少见（分别为 12.3%和 1.4%）。对伊曲康唑、氟康唑和伏立康唑的耐药率分别为 6.9%、3.8%和 3.8%。有 25 株（3.4%）对两性霉素 B 耐药。虽然氟康唑的使用量随时间增加（r(2) = 0.45；P = 0.07），但氟康唑耐药性并未相应增加（P = 0.33）。在我们的机构中，念珠菌血症的发生率较高，但血液念珠菌分离株的氟康唑耐药率仍然较低。
