医院内下呼吸道真菌感染临床特点分析

目的：分析医院内下呼吸道真菌感染的发生率，菌种分布，易感因素和防治措施。为其早期诊断和治疗提供依据。方法：回顾性调查我院1999年1月至2001年12月3年间住院患发生医院内下呼吸道真菌感染的病例。并进行跟踪调查。对相应资料进行统计学分析。结果：3年内共发生医院内下呼吸道真菌感染205例。其感染发生率按年份统计分别为0.28%,0.34%和0.39%。居医院内同期深部真菌感染的首位，占58.53%。其中以白念珠菌感染率最高，单因素和多因素Logistic回归分析皆表明，医院内下呼吸道真菌感染的常见易感因素为老年患，基础疾病，长期应用广谱抗菌药物和免疫抑制剂以及侵袭性操作等。结论：医院内下呼吸道真菌感染发生率呈逐年上升趋势。白念珠菌是主要的病原菌。积极控制易感因素是降低下呼吸道真菌感染发生率的关键。早诊，早治是预防医院内下呼吸道真菌感染和改善预后的重要手段。

Clinical Investigation and Analysis of Nosocomial Fungal Infections in Lower Respiratory Tract

Objective:To provide evidences for early diagnosis and treatment of nosocomial fungal infections in the lower respiratory tract by investigating its incidence,bacterial species distribution,susceptibility factors and prophylaxis methods.Methods:The clinical data and characteristics of the nosocomial fungal infection in the lower respiratory tract from1999through2001were analyzed retrospectively in our hospital.The data were statistically analyzed.Results:Nosocomial fungal infections in lower respiratory tract occured in205cases over the three years and the incidence was0.28%,0.34%and0.39%respectively and the most common pathogenic fungus was candida albicans.The single factor and multinomial logistic analysis showed that the risk factors were the aged,chronic diseases,broad-spectrum antibiotics used for long-term,immunosuppessive agents and invasive manipulations etc.Conclusions:The incidence of nosocomial fungal infections is increasing.The most common pathogenic fungus is candida albicans.The key factor for decreasing the incidence of nosocomial fungal infections in the lower respiratory tract is to control the susceptibility factors.Early diagnosis and treatment are considered to be important measures for preventing and controlling nosocomial fungal infections in lower respiratory tract.