重庆某医院重症医学科深部真菌感染的菌种分布及危险因素分析  

Species distribution and risk factors analysis of deep fungal infection in the intensive care unit of a hospital in Chongqing

作　　者：李继志 龙朝钦 刘俊 LI Jizhi;LONG Chaoqin;LIU Jun(Quality Management Department of Chongqing Red Cross Hospital(Jiangbei District People's Hospital),Chongqing 400020,China;Department of Dermatology(Medical Aesthetics),Liangping District People's Hospital,Chongqing 405200,China)

机构地区：[1]重庆市红十字会医院(江北区人民医院)质量管理科,重庆400020 [2]重庆市梁平区人民医院皮肤(医学美容)科,重庆405200

出　　处：《中国真菌学杂志》2025年第1期59-65,共7页Chinese Journal of Mycology

摘　　要：目的 探讨重症医学科患者深部真菌感染的菌种分布及危险因素。方法 2022年8月—2024年8月收集重庆市红十字会医院(江北区人民医院)重症医学科患者1093例,回顾性分析深部真菌感染发生情况,统计患者的真菌感染部位、菌种分布,按是否感染分为未感染组和真菌感染组,对年龄、性别、肥胖、糖尿病、高血压、吸烟史、饮酒史、低蛋白血症、中性粒细胞减少症、化疗史、留置胃管、低蛋白血症、免疫抑制剂、糖皮质激素、持续肠外营养、机械通气、广谱抗生素、留置导尿管、中心静脉置管等因素进行单因素及多因素logistics回归分析。结果 本院重症医学科收治1093例患者中出现82例深部真菌感染,深部真菌感染发生率为7.50%;主要感染部位为下呼吸道(占64.63%)、泌尿道(占14.63%)、血液(占7.32%)。82例深部感染病例中共检出88株真菌,主要为白念珠菌(占44.32%)、光滑念珠菌(占21.59%)、无名念珠菌(占12.50%)、热带念珠菌(占11.36%)。经单因素分析,非感染组和真菌感染组年龄≥60岁、低蛋白血症、免疫抑制剂、糖皮质激素、持续肠外营养、机械通气、广谱抗生素、留置导尿管、中心静脉置管比较,差异具有统计学意义(P <0.05)。经多因素分析,年龄≥60岁、低蛋白血症、免疫抑制剂、糖皮质激素、持续肠外营养、机械通气、广谱抗生素、留置导尿管、中心静脉置管是重症医学科深部真菌感染的危险因素(P <0.05)。结论 重庆某医院重症医学科深部真菌感染部位多为下呼吸道、泌尿道、血液,真菌菌种主要为白念珠菌、光滑念珠菌、无名念珠菌、热带念珠菌,且存在多种危险因素,宜引起重视。Objective To explore the distribution of fungal species and risk factors for deep fungal infections in critically ill patients.Method From August 2022 to August 2024,1093 patients from the Intensive Care Unit of Chongqing Red Cross Hospital(Jiangbei District People's Hospital)in Chongqing were collected.Retrospective analysis of the occurrence of deep fungal infections,statistical analysis of the fungal infection sites and bacterial species distribution of patients,and classification into uninfected group and fungal infection group based on whether they are infected or not.In this paper,univariate and multivariate logistic regression analysis was carried out on age,sex,obesity,diabetes,hypertension,smoking history,drinking history,hypoproteinemia,neutropenia,chemotherapy history,gastric tube indwelling,hypoproteinemia,immunosuppressants,glucocorticoids,continuous parenteral nutrition,mechanical ventilation,broad-spectrum antibiotics,indwelling urinary catheter,central venous catheterization and other factors.Result Among 1093 patients admitted to the intensive care department of our hospital,82 cases of deep fungal infections occurred,with an incidence rate of 7.50%;The main infection sites are the lower respiratory tract(64.63%),urinary tract(14.63%),and blood(7.32%).A total of 88 strains of fungi were detected in 82 cases of deep infection, mainly including Candida albicans (44.32%), Candida glabrata (21.59%), Candida famata (12.50%), and Candida tropicalis (11.36%). Through univariate analysis, there was a statistically significant difference (P<0.05) between the non infection group and the fungal infection group in terms of age ≥ 60 years, hypoalbuminemia, immunosuppressants, glucocorticoids, continuous parenteral nutrition, mechanical ventilation, broad-spectrum antibiotics, indwelling catheterization, and central venous catheterization. After multiple factor analysis, age ≥ 60 years, hypoalbuminemia, immunosuppressants, glucocorticoids, continuous parenteral nutrition, mechanical ventilation, broad-spec

关 键 词：重症医学科 深部真菌感染 危险因素 

分 类 号：R519[医药卫生—内科学]