血培养真菌阳性患者的抗感染治疗及结果分析

目的分析血培养真菌阳性结果患者感染的性质,提高抗真菌治疗水平,减少抗真菌药物的不良反应。方法利用医院感染实时监控软件跟踪全院血培养结果为真菌阳性的患者,制订个体化给药方案,对真菌血症患者进行抗真菌药物治疗。结果培养结果：2013年某医院血培养真菌阳性130次（55人）,占全部血培养阳性结果的5.12%。感染菌种为：白假丝酵母菌71次,近平滑假丝酵母菌及光滑假丝酵母菌各25次,其他共9株（无名念珠菌4次,阿萨希毛孢子菌、奥默毕赤菌各2次、季也蒙念珠菌1次）。治疗结果：55例患者中出院29例;死亡22例;自动放弃治疗及转院3例;仍在院治疗1例。结论患者罹患真菌血液系统感染死亡率较高,临床药师及时发现并跟踪真菌血液感染患者,可以发挥临床药师的药学技术特色,提高治愈率、降低死亡率,临床药师深入临床协助临床医生合理使用抗真菌药物的方法值得大力推广。

Antifungal Treatment of Blood Culture Positive Patients

Objective To analyze the nature of infection of patients whose results of blood culture were positive,improve the level of antifungal treatment and to reduce adverse reactions.Methods Every weekday morning,Xinglin Hospital Infection Real-time Monitoring System was used to keep track of patients in our hospital whose blood culture results were fungus-positive.Clinical pharmacists collaborated with doctors to analyze the culture results and develop individual dosing regimens before advising doctors on rational use of antifungal drugs.Results In the hospital,there were 130（55people） fungus-positive results,accounting for 5.12 percent of the total of blood culture positive cases in 2013.Bacterial species included Candida albicans（71）,Candida parapsilosis（25）,Candida glabrata（25）,others（9）.Among the 55 patients,29 were discharged from the hospital,22 died,3 gave up treatment or turned to another hospital,1 remained in our hospital.Conclusion The mortality rate is high among patients who suffer from fungal bloodstream infections.Clinical pharmacists can play an important role in treatment if they are capable of quick detection.Clinical pharmacists should be encouraged to work together with clinicians in order to ensure rational use of antifungal drugs.