ICU院内真菌性败血症的发生特点及其防治

目的 探讨ICU患者院内真菌性败血症的发生特点及其防治策略。方法 收集近3年来上海长征医院综合性ICU住院患者院内真菌性败血症51例进行回顾性分析。结果 51例败血症血微生物培养共获得真菌菌株53株，念珠菌是主要病原体(87．14％)；入侵途径以中心静脉导管为最多(35．29％)；总病死率68．63％，为同期ICU病死率的12．71倍；多脏器功能衰竭与感染性休克是预后不良的先兆因素。结论 真菌感染已成为ICU内危重病患者死亡的重要原因。消除易患因素、重视真菌感染的监测、及时合理的抗真菌治疗是降低危重病患者获得性真菌感染发病率及病死率的重要措施。

To study the clinical characteristics, prevention and treatment of nosocomial fungal septicemia of critical ill patients

Objective To study the clinical characteristics, prevention and treatment of nosocomial fungal septicemia.Methods Clinical retrospective study of 51 consecutive patients with nosocomial fungal septicemia.Results 53 fungal strains were isolated from blood. Candida was the predominantly pathogenic organism(87.14%).The most frequent sources of infection were central venous catheters(35.29%).Overall mortality rate was 68.63%.Multi-organ failure and septic shock were the predicting factors of poor prognosis. Conclusions Fungal infection has become prominently fatal cause of critically ill patients. Removing predisposing factors, monitoring fungal pathogen and effective antifunga therapy are important measures to reduce the incidence and mortality of fungal infection.