中文摘要：

目的 了解江西南昌市假丝酵母菌血症病原真菌构成及其药物敏感性.方法 收集 2015年3-10月南昌某医院住院患者送检血标本分离的假丝酵母菌属真菌,扩增真菌的转录间隔间区（ITS区）和核糖体大亚基（26rRNA、D1/D2区）对菌株进行鉴定,同时检测菌株对抗真菌药物的敏感性.结果 共收集血培养阳性标本1 332份,真菌阳性标本74份,占5.56％,其中检出假丝酵母菌属52株,以热带假丝酵母菌为最常见（17株,占32.69％）,其次是白假丝酵母菌和近平滑假丝酵母菌复合体（均为16株,各占30.77％）.ITS区和D1/D2区的鉴定结果相同.52株假丝酵母菌对米卡芬净、卡泊芬净均敏感,两性霉素B的流行病学折点（ECV）结果显示,均为野生型.热带假丝酵母菌对氟康唑和伏立康唑的耐药率分别为29.41％、17.64％,伊曲康唑和泊沙康唑的ECV结果显示,野生型分别占82.35％、94.12％;白假丝酵母菌对氟康唑和伏立康唑的敏感率分别为93.75％、81.25％,伊曲康唑和泊沙康唑的ECV显示,野生型分别占75.00％、81.25％;近平滑假丝酵母菌复合体对氟康唑和伏立康唑均敏感,伊曲康唑和泊沙康唑的ECV结果显示,均为野生型;光滑假丝酵母菌对氟康唑均为中介,伏立康唑、伊曲康唑和泊沙康唑的ECV结果显示,野生型分别占66.67％、100.00％、100.00％.结论 热带假丝酵母菌为江西南昌市假丝酵母菌血症最常见的病原真菌,其次是白假丝酵母菌和近平滑假丝酵母菌复合体,唑类和棘白菌素类抗真菌药物和两性霉素B仍是一线抗真菌药物.

英文摘要：

Objective To explore the constitute and antimicrobial susceptibility of pathogenic fungi causing candidemia in Nanchang City of Jiangxi Province.Methods Candida spp.isolated from blood specimens of patients at a hospital in Nanchang in March-October 2015 were collected, fungal strains were identified by amplifying the internal transcribed spacer （ITS） and large ribosomal subunit （D1/D2 region of 26rRNA）, antifungal susceptibility of fungi was detected.Results A total of 1 332 positive blood culture specimens were collected, including 74 fungal positive specimens, accounting for 5.56%, 52 strains of Candida spp.were obtained, most were Candida tropicalis （n=17,32.69%）,followed by Candida albicans（n=16, 30.77%） and Candida parapsilosis complex （n=16, 30.77%）.Identification results of ITS and D1/D2 region were identical.52 strains of Candida spp.were sensitive to both micafungin and caspofungin, epidemiological cutoff value（ECV） of amphotericin B showed that 52 strains were all wild type.Resistance rates of Candida tropicalis to fluconazole and voriconazole were 29.41% and 17.64% respectively, ECV of itraconazole and posaconazole showed that wild type accounted for 82.35% and 94.12% respectively;resistance rates of Candida albicans to fluconazol and voriconazole were 93.75% and 81.25% respectively, ECV of itraconazole and posaconazole showed that wild type accounted for 75.00% and 81.25% respectively;Candida parapsilosis complex strains were sensitive to both fluconazole and voriconazole, ECV of itraconazole and posaconazole showed that all were wild type;all Candida glabrata strains had intermediate resistance rates to fluconazole, ECV of voriconazole, itraconazole, and posaconazole showed that wild type accounted for 66.67%, 100.00%, and 100.00% respectively.Conclusion Candida tropicalis is the most common pathogenic fungus causing candidemia in Nanchang of Jiangxi, followed by Candida albicans and Candida parapsilosis complex.Azole, echinocandin, and amphotericin B are still first-line ant