摘要
目的调查重症监护病房(ICU)患者院内深部真菌感染的现状及易感因素,加强感染的防治。方法回顾调查ICU 2005年7月-2007年6月798例患者的临床资料,分析真菌感染的危险因素、真菌的种类、耐药性及防治对策。结果798例患者中发生医院深部真菌感染137例,占17.2%,以下呼吸道感染为主,占72.3%,其后依次为泌尿道(7.3%)、肠道(4.4%)和血液(3.6%)等;各种感染性标本共分离真菌180株,主要为白色假丝酵母菌(43.3%)、热带假丝酵母菌(25.6%)和光滑假丝酵母菌(23.3%),对氟康唑、伊曲康唑、5-氟胞嘧啶及两性霉素B均保持良好敏感性(耐药率均≤2.4%);严重的基础疾病、长期应用抗菌药物、激素及侵入性操作是ICU患者真菌感染危险因素。结论合理使用抗菌药物及免疫抑制剂,减少不必要的诊疗操作,早发现、早诊断、早治疗是防治深部真菌感染的关键。
OBJECTIVE To investigate the susceptible factors and the methods of prevention and treatment of nosocomial deep fungal infection in intensive care unit （ICU）. METHODS The clinical information of 798 patients in ICU was investigated from Jul 2005 to Jun 2007. The risk factors, species, drug-resistance and the methods of prevention of fungal infection were analyzed. RESULTS Fungal infections were found in 137 cases （17.2%）. The lower respiratory tract accounted for 72.3M in 137 cases with fungal infection. A total of 180 strains of fungi were isolated, Candida albicans, C. tropicalis and C. glabrata accounted for 43. 3%, 25. 6M and 23. 3%. The resistance characteristics to fluconazole, itraconazole, 5-fluorocytosine and amphotericin B were relatively weak. The factors related to nosocomial fungal infection were the severity of the underlying disease, long-term use of antibiotics and glucocorticoid and invasive procedure. CONCLUSIONS Proper use of antibiotics and immunodepressor, reduction of unnecessary operation and early diagnosis are the keys in prevention of systemic fungal infection.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2008年第11期1544-1546,共3页
Chinese Journal of Nosocomiology
关键词
重症监护病房
真菌感染
Intensive care unit
Fungal infection
