ICU患者假丝酵母菌菌血症的预后危险因素分析  

Risk factors for prognosis of ICU patients with candidemia

作　　者：叶龙强[1] 石林惠[1] 董绉绉[1] 丁毅[1] 蔡挺[2] 

机构地区：[1]宁波市医疗中心李惠利医院重症医学科,浙江宁波315040 [2]宁波市第二医院呼吸内科,浙江宁波315010

出　　处：《中华医院感染学杂志》2016年第1期28-30,共3页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金资助项目(LY13H190008)

摘　　要：目的分析重症监护病房（ICU）假丝酵母菌菌血症患者的临床和微生物特征,评价其死亡的预后危险因素,以指导临床治疗。方法回顾性分析2005年6月-2013年5月医院ICU 69例假丝酵母菌菌血症患者的临床资料,分析病原菌种类、基础疾病、危险因素、预后情况,使用单因素分析及多因素logistic回归分析假丝酵母菌菌血症死亡的相关危险因素;使用SPSS13.0软件对数据进行统计分析。结果血培养共分离到69株假丝酵母菌属,其中白色假丝酵母菌35株占50.7%,光滑假丝酵母菌12株占17.4%,近平滑假丝酵母菌6株占8.7%,热带假丝酵母菌5株占7.2%,经单因素分析及多因素logistic回归分析发现,并发感染性休克（OR=8.601,95%CI为1.756-42.120）、合并细菌菌血症（OR=32.393,95%CI为3.686-284.657）、低蛋白血症（OR=25.496,95%CI为2.876-226.067）为死亡的独立危险因素。结论 ICU假丝酵母菌菌血症以白色假丝酵母菌为主,病死率高,应针对危险因素采取相应治疗措施。OBJECTIVE To observe the clinical and microbiological characteristics of the patients with candidemia in the intensive care unit（ICU）and evaluate the risk factors for the prognosis of death so as to provide guidance for clinical treatment.METHODS The clinical data of 69 patients with candidemia who were treated in the ICU from Jun 2005 to May 2013 were retrospectively analyzed;the distribution of pathogens,underlying diseases,risk factors,and prognosis were observed.The univariate analysis and multivariate logistic regression analysis were carried out to investigate the related risk factors for the death of the patients with candidemia,and the statistical analysis of data was performed with the use of SPSS13.0software.RESULTS A total of 69 strains of Candida were isolated through blood culture,including 35（50.7%）strains of Candida albicans,12（17.4%）strains of Candida glabrata,6（8.7%）strains of Candida parapsilosis,and 5（7.2%）strains of Candida tropicalis.The univariate analysis and multivariate logistic regression analysis indicated that the independent risk factors for the death included the complication of septic shock（OR=8.601,95%CI1.756~42.120）,complication of bacteremia（OR=32.393,95%CI 3.686~284.657）,and hypoalbuminemia（OR =25.496,95%CI 2.876~226.067）.CONCLUSIONThe C.albicans is dominant among the Candidastrains isolated from the ICU patients with candidemia,and the mortality rate is high.It is necessary to take corresponding treatment measures aiming at the risk factors.

关 键 词：重症监护病房 假丝酵母菌菌血症 危险因素 预后 

分 类 号：R379[医药卫生—病原生物学]