Abstract:

Objective To investigate the clinical distribution and drug resistance of inpatients with sterile body fluid fungal infection in Renmin Hospital of Wuhan University,and to provide a reference for etiological diagnosis and the rational use of antibiotics. Methods A total of 222 isolates of fungi isolated from inpatients from April 2016 to June 2018 were analyzed retrospectively. The isolates were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry（MALDI-TOF MS）,and antifungal susceptibility test was carried out by fungal drug sensitivity test plate. Results Among the 222 isolates of fungi,Candida albicans accounted for 35.6%,Candida parapsilosis 20.1%,and Candida tropicalis 18.1%. The top 3 sample sources were blood（45%）,ascites（21.2%） and catheter tips（13.5%）. The top 3 departments were intensive care unit（31.9%）,pancreatic surgery（15.7%） and nephrology department（8.1%）. The susceptibilities of isolates to 5-fluorouracil,itraconazole,fluconazole except for the natural resistance of Candida kruseii to it,voriconazole,amphotericin B and echinocandin except for the natural resistance of Cryptococcus neoformans to it were 97.3%,71.6%,87.8%,91.9%,99.5% and 100.0%,respectively. The drug resistance rates of Candida tropicalis and Candida guilliermondii to azoles are high. Conclusions Candida albicans,Candida parapsilosis and Candida tropicalis are the main fungi detected in sterile body fluid specimens. Except Candida lusitaniae,the other kinds of Candida show different degrees of drug resistance to itraconazole. Echinocandins have the strongest antibacterial activity. Clinic should pay attention to rational antibiotic use.

Key words: Fungus, Sterile body fluid, Drug resistance, Wuhan