ICU老年患者真菌菌血症六例临床特点和病原体分析  

A Retrospective Analysis of Six Fungemia Cases in Intensive Care Unit

作　　者：闫冬[1] 赵呈恩 樊宏[1] 

机构地区：[1]北京航天总医院ICU,北京市100076

出　　处：《中国全科医学》2010年第9期993-994,共2页Chinese General Practice

摘　　要：目的分析ICU老年患者发生真菌菌血症的临床特点和病原体特性,为真菌菌血症的防治提供依据。方法回顾性分析2005年10月—2008年10月我院ICU6例真菌菌血症患者的临床特点。结果低蛋白血症6例,广谱抗生素应用6例,机械通气6例,中心静脉置管6例,留置导尿管6例,急性生理慢性健康评分(APACHEⅡ)≥20分4例,气管插管4例,气管切开2例,激素应用2例,床旁连续性血液滤过治疗2例,肿瘤2例,慢性肾衰竭1例,全胃肠外营养1例;分离出白色假丝酵母菌2例,热带假丝酵母菌2例,光滑假丝酵母菌1例,近平滑假丝酵母菌1例;氟康唑耐药1例。结论ICU真菌血症病死率高与广谱抗生素应用、中心静脉置管、低蛋白血症、高A-PACHEⅡ评分及激素应用等危险因素相关。Objective To analyze the clinical features and pathogen characteristics of fungemia in elderly patients in ICU to provide a basis for its prevention and treatment.Methods A retrospective analysis was conducted on clinical features of 6 fungemia patients admitted to our ICU from October 2005 to October 2008.Results Six patients had hypoproteinemia,6 used broad-spectrum antibiotics,6 were given mechanical ventilation,6 given central venous catheters,6 given indwelling catheters,4 had ≥20 scores of acute physiology and chronic health evaluation （APACHE II）,4 given tracheal tube,2 received tracheotomy,2 used hormone,2 had bedside continuous hemofiltration treatment,2 had tumors,1 had chronic renal failure,1 received total parenteral nutrition;Candida albicans bacteria were isolated in 2 patients,Candida tropicalis yeast in 2,smooth Candida yeast in 1;fluconazole resistance was noted in 1.Conclusion The high fatality rate of ICU Fungemia is related to broad-spectrum antibiotic use,central venous catheters,hypoalbuminemia,high APACHE II scores,and hormone use.

关 键 词：真菌血症 危险因素 重症监护病房 

分 类 号：R714.617[医药卫生—妇产科学]