296例医院内真菌感染分析

目的:了解住院患者深部真菌感染的发生情况.方法:采用回顾性分析方法,对我院2010年2 -12月间的真菌感染病例进行回顾性分析.结果:真菌感染296例;感染以念珠菌属为主,占90.54％,念珠菌属中感染占前三位的分别是白色念珠菌(54.73％)、热带念珠菌(13.18％)、光滑念珠菌(7.09％);真菌感染涉及的科室共有26个,其中,呼吸科感染例数居首,占33.78％;所有真菌感染病例均患有基础疾病,其中患肺部疾病的真菌感染率居首,占32.43％,肿瘤伴发的真菌感染死亡率最高,感染83例,死亡13例,死亡率为15.66％;在治疗上,应用的药物有氟康唑、卡泊芬净、伊曲康唑、伏立康唑、米卡芬净,其中氟康唑应用最频繁,达77.03％;真菌感染伴细菌感染的患者193例,占65.20％;大部分患者接受了侵入性操作.结论:对高龄、患严重基础疾病、需侵入性治疗的患者应采取适当的预防真菌感染的措施,合理选择药物,加强病原菌的监测,尤其对合并感染更要加强警惕,积极治疗,以减轻患者的痛苦.

Analysis of 296 cases of nosocomial fungal infection

Objective： To investigate the current condition about deep fungal infections of patients in hospital.Methods： All cases of fungal infection disease in hospital from February 2010 to December 2010 were analyzed retrospectively.Results： A total of 296 cases of fungal infection disease were investigated.The main pathogenic bacteria were Candida monilia,accounting for 90.54%,in which Candida albicans（54.73%）,Candida tropicalis（13.18%） and Candida glabrata（7.09%） occupied the first place.Data of patients were from 26 departments,mainly from respiratory department（33.78%）.All fungal infective patients were with serious primary diseases,mainly occurred at the respiratory system,accounting for 32.43%.The death rate of fungal infective patients with cancer was 15.66%.The drugs of fluconazole,caspofungin,itraconazole,voriconazole and micafungin were used,and the use frequency of fluconaiole was 77.03%.There were 193 cases of fungal infection accompanied with occurrence of bacterial infection,accountng for 65.20%,in which most patients accepted invasive treatment.Conclusion： It is important to standardize the application of antibiotics.The rational drug therapy,monitoring of pathogenic bacteria and preventative measures should be strengthened especially for the patients with old age,serious primary diseases and who accepted invasive treatment,or concurrent infection.