院内真菌性败血症的临床研究

目的 探讨ICU的院内真菌性败血症的临床特点、药敏情况及防治策略.方法 收集2001-2006年我院ICU的院内获得性真菌性败血症55例进行回顾性分析.结果 55例患者血培养共分离出58株真菌菌株,非白色念珠菌比例高达74.54%.药敏分析显示:两性霉素B敏感率最高,其次为5-氟胞嘧啶,氟康唑对非白色念珠菌敏感率低.92.72%的患者有3种或以上的易患因素,总病死率50.91%.结论 ICU的院内获得性真菌性败血症致病菌株以非白色念珠菌为主,对氟康唑的耐药性增加,病死率高.消除易患因素,加强真菌药敏监测,合理使用抗真菌药物有助于改善预后.

Clinical characteristics of nosocomial fungal septicemia

Objective To study the clinical characteristics, sensitivity analysis and treatment strategies of nescomial fangahnia in critical ill patients. Method Retrospective investigation of 55 consecutive ICU patients with noscomical fungalmia. Results 58 fungal strains were isolated from blood in 55 patients. The proportion of non-albicans species reached to 74.54%. In a sensitivity analysis, the sensitivity of amphotericin B was the best. Fluconazole-resistant candidiasis increased. 92.72% patients had three or more predisposing factors. Over all mortality was 50.91%. Conclutions In noscomical fungalmia, the proportion of non-albicans species and fluconazole-resistant candidiasis increase and mortality is high. Removing predisposing factors, monitoring fungal pathogen and sensitivity analysis, correctly antifungal therapy are more important to improve patients' prognosis.