假丝酵母菌属感染评分预测外科ICU患者侵袭性真菌感染  

Value of Candidascore in prediction of invasive fungal infections in surgical ICU patients

作　　者：廖红[1] 张国勇[1] 李芳秋[1] 李伟[1] 韩丹丹[1] 刘倩[1] 

机构地区：[1]南京军区南京总医院解放军临床检验医学研究所,江苏南京210002

出　　处：《中华医院感染学杂志》2014年第21期5239-5241,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81302536);江苏省科技支撑计划-社会发展基金资助项目(BE2009673)

摘　　要：目的采用假丝酵母菌属评分(CS)以预测普通外科ICU患者侵袭性假丝酵母菌病(IC),弥补血培养方法的不足。方法采集2011年6月-2013年5月普通外科ICU 307例患者资料及微生物检验结果,结合临床诊疗实际,参考国外假丝酵母菌属感染评分标准(CS=2×脓毒症+1×外科手术+1×全肠外营养+1×假丝酵母菌属定植),以CS=3作为预测假丝酵母菌属感染的临界值,并将评分结果与真菌培养结果进行比较分析。结果 307例ICU患者中,CS≥3者145例占47.2%;确诊IC感染患者34例,感染率为11.1%;CS≥3的确诊感染IC患者33例,占总体确诊感染IC患者总数的97.1%。结论假丝酵母菌属评分方法早期预测ICU患者侵袭性假丝酵母菌病具有一定的价值,对临床预防性应用抗真菌药物有一定的指导意义。OBJECTIVE To assess the value of Candida score （CS） in prediction of Invasive Candidiasis （IC） in surgical ICU patients so as to make up for the inadequacy of blood culture method .METHODS From Jun 2011 to May 2013 ,the case data and the results of microbiological examination were collected from 307 patients in the ab-dowinal surgical ICU .Based on the practical situation of the clinical diagnosis and treatment ,CS=3 was set as the critical value for the predication of Candida infections by referring to the international scoring standard for Candi-da infections （CS=2 × sepsis plus 1 × surgery plus 1 × total parenteral nutrition plus 1 × colonization of Candida） ,and the scoring results were compared with the results of fungal culture .RESULTS Of the 307 ICU patients ,145 were with the CS ≥3 ,accounting for 47 .2% ;34 cases were confirmed as the IC ,with the infection rate of 11 . 1% .Among the patients with the CS ,no less than 3 ,33 cases were with IC ,accounting for 97 .1% among the to-tal cases of proven IC .CONCLUSIONS The Candida scoring method has certain value in early prediction of inva-sive Candidasis infections in the ICU patients and has certain significance to guide the clinical prophylactic use of antifungal agents .

关 键 词：侵袭性假丝酵母菌病 假丝酵母菌属 感染评分 重症监护病房 

分 类 号：R379[医药卫生—病原生物学]