PICU患儿念珠菌感染的危险因素及预测因素分析  

Risk factors and predictors for candidemia in pediatric intensive care unit patients

作　　者：周华[1] 吉山宝[1] 沈南平[1] 

机构地区：[1]南京医科大学附属无锡市人民医院儿急诊科,江苏无锡214023

出　　处：《南京医科大学学报（自然科学版）》2011年第4期557-560,共4页Journal of Nanjing Medical University(Natural Sciences)

摘　　要：目的:了解儿童念珠菌感染的临床危险因素并进行风险预测。方法:回顾性分析2001～2010年念珠菌培养阳性的本院儿科重症监护病房(PICU)患儿的临床资料。按1∶1比例选择年龄和性别相似、同期住院的念珠菌培养阴性PICU患儿作为对照。运用logistic回归分析相关危险因素并进行念珠菌感染的概率预测。结果:共有107例PICU患儿念珠菌培养阳性,年感染率具有上升的趋势。恶性肿瘤、中心静脉置管、糖肽类抗生素与抗厌氧菌抗生素使用超过3天均是独立的风险预测因素,其中中心静脉置管的校正后的OR值为25.68(95%CI:8.72～97.47)。当上述4个因素均存在时,PICU患儿念珠菌感染的概率为0.36(95%CI:0.01～0.97)。结论:应积极干预PICU患儿念珠菌感染的危险因素。Objective：To investigate the risk factors for candidemia in pediatric intensive care unit（PICU）patients.Methods：A population-based case-control study of PICU patients was conducted from 2001 to 2010.Patients with candidemia infection were identified using laboratory records,and control patients without candidemia infection were selected from PICU rosters.Following multivariate analysis,logistic regression analysis was performed to determine risk factros and predicted probabilities of candidemia.Results：One hundred and seven patients with candidemia infection were identified.Factors independently associated with candidemia included presence of a central venous catheter [odds ratio（OR）=25.68,95% confidence interval（CI）：8.72~97.47],malignancy（OR=5.34,95%CI：1.80~15.22）,use of vancomycin for ≥4 days（OR=5.57,95%CI：1.74~17.49）,and receipt of agents with activity against anaerobic organisms for ≥4 days（OR=3.66,95%CI：1.31~7.53）.Predicted probability of having various combinations of the aforementioned factors ranged from 0.004 to 0.36.Conclusion：Future efforts should focused on validation of these risk factors identified in different PICU population and development of interventions for prevention of candidemia infection.

关 键 词：儿科重症监护病房 念珠菌感染 危险因素 

分 类 号：R519.3[医药卫生—内科学]