重型肝炎合并医院真菌感染的临床特点及影响因素  

Clinical characteristics and risk factors of nosocomial fungal infection in patients with severe hepatitis

作　　者：张惠勇[1] 沈培根 徐成润[1] 刘双平 吴秀欣 ZHANG Hui-yong;SHEN Pei-gen;XU Cheng-run;LIU Shuang-ping;WU Xiu-xin(909s Hospital Southeast Hospital Affiliated to Xiamen University Fujian,Zhangzhou 363000,China)

机构地区：[1]解放军联勤保障部队第九〇九医院感染科福建省厦门大学附属东南医院感染科

出　　处：《中华医院感染学杂志》2019年第22期3405-3408,3452,共5页Chinese Journal of Nosocomiology

基　　金：福建省自然科学基金资助项目(7467345)

摘　　要：目的探究重型肝炎合并医院真菌感染的临床特点及影响因素。方法选取2015年8月-2018年8月厦门大学附属东南医院收治的126例重型肝炎合并医院真菌感染患者为感染组,选取同期重型肝炎未出现医院真菌感染患者126例为未感染组。收集并分析两组患者临床资料,研究重型肝炎合并医院真菌感染临床特征以及影响因素。结果感染组患者共发生感染例数为147次,以腹腔感染、胃肠道感染为主;共分离真菌151株,其中白假丝酵母占66.23%;感染组住院时长超过40 d、行诊疗侵袭性操作、抗菌药物使用、低蛋白血症、白细胞减少以及存在合并疾病患者均高于非感染组;多因素Logistic回归分析显示,长时间住院、诊疗侵袭性操作、抗菌药物的使用、低蛋白血症、白细胞减少以及合并疾病是重型肝炎患者发生医院真菌感染的影响因素。结论临床上对于重型肝炎患者需要减少不必要的诊疗侵袭性操作、抗菌药物的使用,以降低真菌感染风险。OBJECTIVE To explore the clinical characteristics of severe hepatitis complicated with nosocomial fungal infection and the influencing factors.METHODS 126 patients with severe hepatitis complicated with nosocomial fungal infection were selected as the infection group from August 2015 to August 2018.The patients without nosocomial fungal infection in severe hepatitis during the same period were selected as the non-infection group.The clinical data of two groups were collected and analyzed to study the clinical characteristics and influencing factors of severe hepatitis complicated with nosocomial fungal infection.RESULTS There were 147 infections in the infected group.The abdominal infection rate and gastrointestinal infection rate in the infected group were higher than those in other parts.151 strains of fungi were isolated from the infected group.The infection rate of Candida albicans was higher than that of other fungi.The length of hospitalization in the infected group was more than 40 days.Multivariate logistic regression analysis showed that long-term hospitalization,invasive operation of diagnosis and treatment,use of antibiotics,hypoproteinemia,leukopenia and the presence of complications were higher than those in non-infectious group.As well as the complications are the influencing factors of nosocomial fungal infections in patients with severe hepatitis.CONCLUSION In order to reduce the risk of fungal infection,it is necessary to reduce unnecessary invasive procedures and antibiotics for patients with severe hepatitis.

关 键 词：重型肝炎 真菌感染 预测模型 临床特点 影响因素 

分 类 号：R47[医药卫生—护理学]