重症监护室患者深部真菌感染因素分析及预防对策

目的分析该院重症监护室（ICU）患者深部真菌感染危险因素,并探讨相应的预防对策。方法从该院病案室资料库中选取60例ICU深部真菌感染患者的资料,对真菌菌种类型、菌种分布、感染的危险因素、临床表现、抗菌药物应用等进行调查、分析。结果 60例患者中,ICU深部感染真菌以白色念珠菌为主（41.67%）;发生真菌感染共82例次,其中呼吸系统感染最常见,共28例次（34.15%）;感染危险因素包括应用广谱抗菌药物（79.23%）、治疗15d后留置尿管（73.33%）、接受治疗7d后行中心静脉置管（71.39%）、术后留置引流管（71.39%）、接受治疗7d后行机械通气（70.00%）;感染前使用的抗菌药物以青霉素为主（68.32%）。结论 ICU深部真菌感染具有较高的发病率,应尽量减少和避免可能导致感染的各种危险因素,并采取有效的预防措施。

Analysis and prevention countermeasures of ICU patients with deep fungal infection

Objective To analyze risk factors of intensive care unit （ICU） patients with deep fungal infection,and to explore the preventive countermeasures. Methods Data of 60 patients with deep fungal infection in ICU was selected from our hospital medical record room database. The fungal types and distribution,risk factors,clinical manifestation and application of antibacterial drug were investigated and analyzed. Results In the 60 patients,the candida albican was the main species in deep fungal infection of ICU （41. 67%） ; fungal infection occurred in 82 cases,and respiratory system infection was the most common with a total of 28 cases （accounted for 34. 15%） ; risk factors included the use of broad-spectrum antibiotics （79. 23%） ,indwelling catheter after 15d treatment（73. 33%） ,central venous catheterization after 7d treatment（71. 39%） , indwelling drainage tube after operation （71. 39%） ,accepting mechanical ventilation after 7d treatment（70. 00%） ,penicillin, as the main antibiotic medicine,was used before infection（68. 32%） . Conclusion It has a higher incidence of deep fungal infection in ICU,therefore,we should try to reduce and avoid possible risk factors causing infection and take effective measures to prevent.