成人白色念珠菌与非白色念珠菌血流感染相关危险因素分析  

Risk factors and analysis of Candida albicans and non-Candida albicans bloodstream infection in adult patients

作　　者：彭敏飞 厉世笑[2] 朱士土[3] 赵雷 秦佳佳 蔡莺莺 PENG Min-fei;LI Shi-xiao;ZHU Shi-tu;ZHAO Lei;QIN Jia-jia;CAI Ying-ying(Zhejiang Chinese Medical University,Hangzhou,Zhejiang 310053,China)

机构地区：[1]浙江中医药大学,浙江杭州310053 [2]浙江省台州医院检验科,浙江临海317000 [3]临海市妇幼保健院儿科,浙江临海317000 [4]台州学院医学检验,浙江台州318000

出　　处：《中国卫生检验杂志》2020年第15期1888-1891,共4页Chinese Journal of Health Laboratory Technology

基　　金：浙江省医药卫生科技项目(2015KYB437)。

摘　　要：目的探讨成人念珠菌血流感染的危险因素,为临床评估患者预后和预防血流感染提供科学依据。方法回顾性分析2014年1月-2018年12月台州医院念珠菌血流感染的临床及微生物学资料。结果184例念珠菌血流感染患者中,白色念珠菌78例,热带念珠菌48例,近平滑念珠菌32例,光滑念珠菌12例,其他念珠菌14例。影响白色念珠菌与非白色念珠菌的危险因素有腹腔感染、深静脉穿刺、机械通气、抗生素使用>30 d。其中机械通气、深静脉穿刺是白色念珠菌血流感染的独立危险因素(P<0.05)。所有菌株对两性霉素B和5-氟胞嘧啶的敏感率均为100.0%,对氟康唑的耐药率较高。结论念珠菌血症发生率高,且真菌谱不断变迁,非白色念珠菌感染比例增加,对氟康唑的耐药性增加,临床科室应针对感染的危险因素制定有效的控制措施。Objective To investigate the risk factors of Candida albicans and non-Candida albicans bloodstream infection in adult patients,so as to provide basis for the prevention of bloodstream infections and clinical evaluation on patients’prognosis.Methods The clinical and microbiological data of candida bloodstream infection in Taizhou Hospital from January 2014 to December 2018 were retrospectively analyzed.Results In 184 cases with Candida bloodstream infection,78 cases were Candida albicans,48 cases were Candida tropicalis,32 cases were Candida parapsilosis,12 cases were Candida glabrata,14 cases were other Candida.The risk factors of Candida albicans and non-Candida albicans infection included abdominal infection,deep venous puncture,mechanical ventilation,antibiotics use>30 d.Mechanical ventilation and deep venous puncture were the independent risk factors for the infection of Candida albicans(P<0.05).The sensitive rate of all the isolates to amphotericin B and 5-flucytosine was 100.0%,and the resistance to fluconazole is higher.Conclusion The incidence of Candidemia is high,the spectrum of fungi is changing,and the proportion of the non-Candida albicans is increased,and the resistance to fluconazole is increased.Clinical departments should make effective control measures to prevent the risk factors of infection.

关 键 词：念珠菌血症 危险因素 耐药性 

分 类 号：R446.5[医药卫生—诊断学]