呼吸重症监护病房深部真菌感染特点及其相关危险因素分析  

High Risk Factors and Clinical Analysis of Nosocomial Pulmonary Fungal Infection in Respiratory Intensive Care Unit

作　　者：黄玉蓉[1] 郭素君[1] 吴秋英[2] 李文军[3] 闵丽[1] 王晓园[1] 

机构地区：[1]新疆生产建设兵团医院呼吸内科,新疆乌鲁木齐830000 [2]新疆生产建设兵团医院ICU,新疆乌鲁木齐830000 [3]新疆生产建设兵团医院药剂科,新疆乌鲁木齐830000

出　　处：《中华医院感染学杂志》2010年第14期2033-2035,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解呼吸重症监护病房(RICU)患者深部真菌感染的发生率、病死率,并对其相关危险因素进行分析,探讨早期诊治的对策。方法采用回顾性调查研究的方法对2005年1月-2008年12月医院RICU 39例深部真菌感染患者的临床资料进行分析总结。结果近4年RICU共诊断肺部真菌感染39例,其发病率显著高于同时期普通病房的发病率(17.18%比2.35%,P<0.005);慢性阻塞性肺疾病和重症细菌性肺炎是最常见的呼吸系统基础疾病,分别占43.59%和25.64%;有创通气、有创导管、长期使用抗菌药物、大剂量使用激素等是RICU真菌感染患者常见的危险因素;假丝酵母菌属是最常见的感染菌,尤其是白色假丝酵母菌(26株,66.67%),真菌对唑类药物敏感性较高,尤其是氟康唑,但对其他唑类药物出现不同程度的耐药。结论 RICU患者院内肺部真菌感染的发病率明显高于普通病房,其中假丝酵母菌属感染所占比例较高,氟康唑治疗效果较好。OBJECTIVE To determine the risk factors and clinical outcome of nosocomial pulmonary fungal infections in respiratory intensive care unit（RICU）.METHODS The clinical data of 39 cases of RICU patients with deep fungal infection from Jan 2005 to Dec 2008 was analyzed with the retrospective study and investigation.RESULTS A total of 39 cases of pulmonary fungal infections in RICU were diagnosed in the recent 4 years and the morbidity rate was significantly higher than that of the same period in common wards（17.18% vs 2.35%,P〈0.05）.The chronic emphrix pulmonary disease and intensive bacterial pneumoni were the most common disease,accounted for 43.59% and 25.64%,respectively,Candida spp was the most common infectious bacteria,especialy the Candida albicans（26 strains,66.67%）.Fungi were highly sensitive to de-drugs,especialy fluconazole.CONCLUSIONS The morbidioy rate of pulmonary fungal infection in RICU is significantly higher than that in the common ward.Fluconazole has the better treatment efficacy.

关 键 词：呼吸重症监护病房 真菌感染 危险因素 

分 类 号：R379[医药卫生—病原生物学]