目的 了解2015-2019年甘肅醫(yī)學(xué)院附屬醫(yī)院慢性阻塞性肺疾病急性加重期（AECOPD）患者繼發(fā)肺部真菌感染率變化趨勢、分布及耐藥性特點。方法 提取2015-2019年甘肅醫(yī)學(xué)院附屬醫(yī)院AECOPD患者臨床真菌分離及藥敏相關(guān)數(shù)據(jù)。結(jié)果 2015-2019年AECOPD患者繼發(fā)肺部真菌感染率為13.37%，且呈上升趨勢，真菌感染率從2015年的10.88%上升至2019年的15.71%；共分離出6種真菌，以白色念珠菌（52.41%）、光滑念珠菌（25.13%）、熱帶念珠菌（12.30%）、曲霉菌（8.02%）為主；主要以真菌與細(xì)菌的混合感染存在（64.61%），其中以真菌與革蘭陰性菌混合感染為主（70.43%）。氟康唑?qū)Ω鞣N念珠菌耐藥率接近30%，對曲霉菌耐藥率大于90%，伏立康唑和兩性霉素B對各種念珠菌和曲霉菌的耐藥率較小。結(jié)論 真菌感染在AECOPD患者中呈明顯增長趨勢，白色念珠菌、光滑念珠菌、熱帶念珠菌和曲霉菌常見，且主要為與細(xì)菌混合感染存在，氟康唑?qū)φ婢退幝瘦^高，伏立康唑成為治療真菌感染的首選。

Objective To investigate the trend of pulmonary fungal infection rate and drug resistance in patients with AECOPD in Affiliated Hospital of Gansu Medical College from 2015 to 2019. Methods According to the data on clinical isolates and drug susceptibility from 2015 to 2019 in Affiliated Hospital of Gansu Medical College, the distribution characteristics and the resistance profile of fungi were analyzed, as well as the trend. Results From 2015 to 2019, the incidence of pulmonary fungal infection in AECOPD patients was 13.37%, and it was on the rise. The infection rate increased from 10.88% (2015) to 15.71% (2019). Six fungi were isolated, mainly were Candida albicans (52.41%), Candida glabrata (25.13%), Candida tropicalis (12.30%), and Aspergillus (8.02%). Fungal infection mainly was mixed infection with bacteria (64.61%), in which fungi and Gram-negative bacteria mixed infection (70.43%). The resistance rate of fluconazole to various Candida were near to 30%, and to Aspergillus was more than 90%, and the resistance rate of voriconazole and amphotericin B to various Candida and Aspergillus were lower. Conclusion Fungal infections shows a significant growth trend in AECOPD patients. C. albicans, C. glabrata, C. tropicalis, and Aspergillus are common, and mainly mixed with bacteria. Fluconazole has a high resistance rate to fungi, and voriconazole is the first choice for the treatment of fungal infections.

R978.1

甘肅省高等學(xué)校創(chuàng)新能力提升項目（2019B-198）