EICU侵袭性真菌感染临床特点及病原学分析

目的 探讨急诊重症监护病房(EICU)重症患者真菌感染的临床特点.方法 对2009年1月-2010年12月入住医院EICU的106例侵袭性真菌感染重症患者,进行回顾性调查分析.结果 106例真菌感染患者中分离菌株117株,白色假丝酵母菌72株占61.5％,非白色假丝酵母菌45株占38.5％,主要感染部位为呼吸道、泌尿道及血液为主,其主要诱因为不合理使用抗菌药物、长期使用激素、中心静脉置管、人工机械通气及留置导尿管等,非白色假丝酵母菌与白色假丝酵母菌感染死亡率比较,差异有统计学意义(P＜0.01).结论 EICU重症患者真菌感染以白色假丝酵母菌最常见,感染部位以呼吸道为主,其中不合理使用抗菌药物、长期使用激素、中心静脉置管、人工机械通气及留置导尿管为高危因素,真菌感染死亡患者多为非白色假丝酵母菌感染.

Clinical characteristics and etiology of invasive fungal infections in EICU

OBJECTIVE To study the clinical characteristics of invasive fungal infections in patients in emergency intensive care unit(EICU).METHODS A total of 106 patients with severe invasive fungal infections who enrolled in EICU from Jan 2009 to Dec 2010 were retrospectively investigated and analyzed.RESULTS Totally 117 strains of fungi were isolated from 106 patients with fungal infections,among which there were 72 strains(61.5%) of Candida albicans and 45(38.5%)strains of non-C.albicans;the main infection sites were respiratory tract,urinary tract and blood;the predisposing factors for the fungal infections included the irrational use of antibiotics,long-term use of hormones,central venous catheterization,mechanical ventilation and indwelling catheter;the difference in the mortality between the patients with C.albicans infections and non-C.albicans infections was statistically significant(P<0.01).CONCLUSION C.albicans is the most common pathogens causing fungal infections in EICU,the predominant infection site is respiratory tract;unreasonable use of antibiotics,long-term use of hormones,central venous catheterization,mechanical ventilation and indwelling catheters are recognized as high risk factors.Non-C.albicans infection is the main cause of death among the patients with fungal infections.