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目的探讨黑曲霉菌引起胃癌患者血流感染的实验诊断方法和治疗措施。方法采用BacT/Alert 3D全自动血培养仪进行血培养;仪器报警后,结合GM、G试验、sCRP和PCT等血清学结果,将标本转种于沙氏培养基行真菌培养。根据其菌落特点和镜下形态等特征鉴定真菌种类,采用MIC方法进行真菌体外药敏试验。结果从该患者血培养标本中分离出真菌并鉴定为黑曲霉菌,体外药敏试验显示对伏立康唑、卡泊芬净有较低的MIC值,分别为0.25μg/mL、0.06g/mL.遂选用伏立康唑治疗取得满意效果。结论通过行血培养,结合GM和G试验等血清学方法及sCRP和PCT等感染指标,可指导曲霉菌的培养和鉴定。
Objective To explore the experimental diagnosis and treatment of bloodstream infection caused by Aspergillus niger in gastric cancer patients. Methods BacT / Alert 3D automated blood culture instrument was used for blood culture. After alarm, the samples were switched to culture in Sabouraud medium with GM, G test, sCRP and PCT serological results. According to the characteristics of their colonies and microscopic morphology and other characteristics identified fungi, using MIC method fungal in vitro susceptibility testing. Results The fungus was isolated from the blood culture samples of this patient and identified as Aspergillus niger. In vitro susceptibility test showed that MICs of voriconazole and caspofungin were lower, 0.25μg / mL and 0.06g / mL, respectively Choose voriconazole treatment achieved satisfactory results. Conclusion Serum culture, combined with GM and G serological tests and sCRP and PCT and other indicators of infection, can guide Aspergillus culture and identification.