血液病房医院真菌感染的特征与危险因素分析

目的研究血液病房住院患者医院真菌感染特征及危险因素,探讨真菌感染的预防控制措施。方法回顾性调查2006-2010年收治的4243例血液病患者,对其真菌感染特征及相关危险因素进行分析。结果 4243例患者发生医院感染1401例次,例次感染率为33.0%,其中真菌感染478例次,例次感染率为11.3%,真菌感染发病率逐年升高;基础疾病以急性白血病为主,占61.1%;真菌感染部位以口咽部居首,占59.2%,其次为肺部,占18.2%;以肺部及血液真菌感染治疗费用最高;粒细胞缺乏、长期住院(≥14d)、长期应用广谱抗菌药物(≥7d)、原发疾病未缓解是医院真菌感染的最主要危险因素。结论血液病患者医院真菌感染发病率升高,危险因素多,治疗费用高,需采取综合措施有效降低真菌感染的发病率。

Characteristics and risk factors for fungal infections in hematology ward

OBJECTIVE To study the characteristics,risk factors,prevention and control measures for fungal infections in patients of hematology ward.METHODS A total of 4243 cases of hospitalized patients in hematology ward from 2006 to 2010 were investigated retrospectively.Statistical analysis of the characteristics of fungal infections and risk factors was carried out.RESULTS Totally 1 401 case times in 4243 cases caught the hospital infections(33.0%),among which 478 case times were fungal infections(11.3%).The fungal infection rate was increasing year by year;the acute leukemia was the major underlying disease,accounting for 61.1%.Oral and pharynx infection occupied the first place(59.2%),followed by lung infection(18.2%);the medical cost on the lung and blood fungal infections was the highest;the agranulocytosis,long hospital stay(≥14 d),long term use of broad spectrum antibiotics(≥7 d),and no remission of primary diseases were predominant risk factors for fungal infections.CONCLUSION The incidence of fungal infection in hemotology patients is increasing with more risk factors and high medical costs.Integrated prevention and control measures should be adopted to reduce the incidence of fungal infections.