摘要
目的:分析酵母样真菌致医院内感染的危险因素及其耐药性,为合理使用抗真菌药物,控制医院内感染提供方法学依据。方法:采用系统回顾性调查研究方法,对我院2 0 0 2年～2 0 0 4年由酵母样真菌引起的医院内感染的6 5 8例病例进行分析。结果:主要内源性危险因素是抗生素滥用、严重基础疾病、年龄>5 5岁、住院时间>2 0d、激素应用、化疗、免疫抑制剂使用;外源性危险因素是介入治疗、病室内环境、温度和湿度等。酵母样真菌主要以白假丝酵母菌(6 9 4 % )、热带假丝酵母菌(19 2 % )、近平滑假丝酵母菌(6 8% )、克柔假丝酵母菌(2 % )等为主;2 0 0 2年～2 0 0 4年酵母样真菌致医院内感染所占医院感染率呈逐年增高趋势,分别为10 2 %、18 2 %和2 5 6 %。酵母样真菌对5 -氟胞嘧啶(95 5 % )、两性霉素B (97 3% )、制霉菌素(96 4 % )、氟康唑(94 2 % )有较高的敏感率,对咪康唑(14 2 % )、酮康唑(14 2 % )、益康唑(14 2 % )有相对比较高的耐药率。结论:为有效控制酵母样真菌的医院内感染,应考虑酵母样真菌致医院内感染的各种危险因素,严格消毒管理制度,合理使用抗真菌药物。
Objective:To analyze risk factors and drug resistance for hospital infection by Yeast-like fungi,and to provide guideline of control hospital infection and suitable anti-fungal medicine.Methods:The clinical data 658 cases associated with infection by Yeast-Like Fungi were studied and an analyzed retrospectively,which came from our hospital between 2002 and 2004.Results: The chief inside risk factors were application of antibiotics, severe primary disease, age>55 years old, hormone, immune inhibitor, chemotherapy, the chief outside risk factors are invasive operation and the environment, temperature and humidity of the ward and so on. The Yeast-Like Fungi mainly was Candida albicans(69.4%), C. tropicalis(19.2%), C. parapsilosis(6.8%), C. krusei(2%) and so on . From 2002 to 2004, the rate of the hospital infection associated with Yeast-Like Fungi was rising steadily every year,with 10.2% in 2002,18.2% in 2003,and 25.6% in 2004.Yeast-Like Fungi were relatively sensitive to 5-Flucytosine(95.5%), Amphotericin B(97.3%), Nystain(96.4%), Fluconazole(94.2%), and resistant to Miconazole(14.2%), Ketoconazole(14.2%), Econazole(14.2%).Conclusions:In order to control the hospital infection associated with Yeast-Like Fungi effectively, all kinds of the risk factors associated with infection by Yeast-Like Fungi must be considered, anti-fungal medicine should be used reasonably, the isolation should be performed strictly.
出处
《现代预防医学》
CAS
北大核心
2005年第6期663-665,共3页
Modern Preventive Medicine
关键词
酵母样真菌
医院内感染
危险因素
耐药性
Yeast-Like Fungi
Hospital infection
Risk Factor
Drug Resistance
