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| 題 名 | 北部某區域級教學醫院致病酵母菌與藥物感受性分析=The Distribution of Species and Drug Susceptibilities of Pathogenic Yeasts Isolated from Patients in a Regional Teaching Hospital in Northern Taiwan |
|---|---|
| 作 者 | 葉竹君; 劉翠萍; 江妮蓉; 林巧梅; 蔡德君; 郭倩妤; 謝禮雲; 鄭舒倖; 陳正斌; 羅秀容; | 書刊名 | 感染控制雜誌 |
| 卷 期 | 36:1 2026.02[民115.02] |
| 頁 次 | 頁1-15 |
| 分類號 | 419.29 |
| 關鍵詞 | 酵母菌真菌; 抗藥性; 熱帶念珠菌; Yeast; Drug resistance; Candida tropicalis; |
| 語 文 | 中文(Chinese) |
| DOI | 10.6526/ICJ.202602_36(1).0001 |
| 中文摘要 | 近十年來,台灣黴菌抗藥性監測計畫發現,臨床分離之Candida tropicalis(熱帶念珠菌)與環境中對fluconazole(氟康唑)具抗藥性的菌株親緣關係密切,皆屬於clade 4基因分群。類似現象亦在其他熱帶與亞熱帶地區(如中國、澳大利亞、泰國及新加坡)被陸續報導,顯示此基因分群已具區域性流行潛勢。為了解區域級教學醫院酵母菌感染的現況,本研究分析自114位病人臨床檢體中分離的121株酵母菌。最常見菌種為Candida albicans(白色念珠菌,57.9%),其次為Nakaseomyces glabratus(光滑念珠菌,15.7%)、C. tropicalis(9.9%)、Candida parapsilosis(近平滑念珠菌,8.3%)、Cryptococcus neoformans(新型隱球菌,3.3%)及其他菌種(4.9%)。檢體來源以尿液(54.5%)為主,其次為血液(20.7%)與痰液(19%)。其中7件檢體為混合菌感染,以C. albicans / C. parapsilosis組合最常見。藥物感受性試驗結果顯示,amphotericin B(兩性黴素B)與anidulafungin(助黴飛)對多數菌株具良好活性。Azoles(唑類)對C. albicans及C. parapsilosis的感受性均為100%,但12株C. tropicalis中有3株(25%)對fluconazole具抗藥性,其中2株對voriconazole(伏立康唑)亦具交叉抗藥性。多位點序列分型顯示,3株抗藥菌皆屬clade 4基因分群。研究結果顯示,本院C. tropicalis感染排序為Candida第三名,其重要性不容小覷,fluconazole抗藥C. tropicalis皆為clade 4基因分群,amphotericinB與anidulafungin對多數菌株仍具良好感受性。建議醫療人員對於非白色念珠菌感染不可輕忽,要依臨床狀況與藥物感受性結果來治療念珠菌感染的病人。 |
| 英文摘要 | A predominant fluconazole-resistant Candida tropicalis with clade 4 genotype causing candidemia in humans, has been found in both clinical and agriculture contexts. It has not only been found in Taiwan, but in other tropical/subtropical areas including China, Australia, Thailand, and Singapore. In the present study, we randomly analyzed 121 yeast samples isolated from 114 patients in a regional hospital. The most common pathogenic species was Candida albicans (57.9%), followed by Nakaseomyces glabratus (Candida glabrata) (15.7%), C. tropicalis (9.9%), Candida parapsilosis (8.3%), Cryptococcus neoformans (3.3%), and others (4.9%). The common sources were urine (54.5%), followed by blood (20.7%), sputum (19%), pus (3.3%), and cerebrospinal fluid (CSF) (2.5%). Seven specimens were found to harbor more than one species: five were a combination of C. albicans and N. glabratus, and one was C. albicans and C. parapsilosis, and the other was C. albicans and C. tropicalis. Approximately 25% (3/12) of C. tropicalis were resistant to fluconazole and all belonged to the clade 4 genotype. Two were cross-resistant to voriconazole. Our findings demonstrate that C. tropicalis fluconazole-resistant with clade 4 genotype exists in Taiwan. Non-albicans Candida infections should be handled with caution and treated appropriately based on clinical conditions and susceptibility reports. |
本系統中英文摘要資訊取自各篇刊載內容。