光滑念珠菌血流感染20例临床分析  

Candida glabrata bloodstream infection:a retrospective analysis of 20 cases

作　　者：苏青青 顾洁[1] 陈延斌[1] SU Qingqing;GU Jie;CHEN Yanbin(Department of Respiratory and Critical Care Medicine,the Firts Affiliated Hospital of Soochow University,Suzhou Jiangsu 215000,China)

机构地区：[1]苏州大学附属第一医院呼吸与危重症医学科,江苏苏州215000

出　　处：《中国感染与化疗杂志》2020年第1期23-26,共4页Chinese Journal of Infection and Chemotherapy

摘　　要：目的探讨光滑念珠菌血流感染的临床特点。方法收集苏州大学附属第一医院2004年1月-2017年12月确诊的光滑念珠菌血流感染20例,分析其临床表现、易感因素、治疗及预后。结果20例患者的平均年龄(67±15)岁;主要症状为发热(n=19,95.0%),未见其他特异性表现;大部分患者(n=19,95.0%)在就诊时存在至少1种基础疾病;入住重症监护室(ICU)者10例(50.0%),有侵袭性操作者19例(95.0%),应用广谱抗生素≥1周者16例(80.0%);确诊时急性生理与慢性健康状况评分(APACHEⅡ评分)(15.3±6.3)分、全身性感染相关性器官功能衰竭评分(sepsisrelated organ failure assessment,SOFA评分)(7.0±4.6)分;20例患者中治愈11例,死亡9例。结论高APACHEⅡ评分和SOFA评分与预后不良有关;对于年龄>60岁、长期使用广谱抗生素、入住ICU、合并有恶性肿瘤等基础疾病及各种侵袭性操作的患者,若出现发热时,应积极留取血培养,以便尽早明确诊断,开始有效的抗真菌治疗。Objective To explore the clinical features of Candida glabrata bloodstream infection.Methods A retrospective analysis was performed by collecting clinical data of underlying diseases,risk factors,therapy,and prognosis of Candida glabrata bloodstream infection in the First Affiliated Hospital of Soochow University from January 2004 to December 2017.Results The average age of the 20 patients was(67±15)years old.Most patients had fever(95.0%,19/20)with at least one underlying disease(95.0%,19/20).Of the 20 patients,10 were admitted to ICU,19 received invasive procedures,and 16 received broad spectrum antibiotics longer than 1 week.At the time of diagnosis,APACHE II score and SOFA score were(15.3±6.3)and(7.0±4.6)points,respectively.Overall,11 patients were cured and 9 died.Conclusions High APACHE II score and SOFA score are associated with poor prognosis.Blood culture should be performed promptly if febrile patients are older than 60 years old,with long-term use of broad spectrum antibiotics,admission to ICU,with comorbidity such as malignant tumors or receiving invasive procedures,for the purpose to make early definite diagnosis and initiate effective antifungal therapy as soon as possible.

关 键 词：光滑念珠菌 血流感染 败血症 回顾性分析 

分 类 号：R639[医药卫生—外科学] R379.411[医药卫生—临床医学]