摘要
目的探讨肿瘤患者中心静脉导管(CVC)真菌感染的分布与发生率,分析其相关因素,提出有效的预防改进措施。方法回顾性分析2011年1-10月医院留置CVC的200例肿瘤患者的感染情况及相关因素。结果CVC相关性真菌感染发生率为15.0%,其中26例单纯CVC感染(CVC-RI),4例合并真菌血症,其中近平滑假丝酵母菌、热带假丝酵母菌、皱褶假丝酵母菌、白色假丝酵母菌及光滑假丝酵母菌分别占53.3%、16.7%、13.3%、10.0%及6.7%;CVC感染发生率与患者性别、年龄、肿瘤类型及手术与否无相关性,不同部位置入CVC的感染率差异有统计学意义(P<0.05),CVC相关感染的患者导管留置时间比较,差异有统计学意义(P<0.05);26例患者拔出CVC后感染自愈,4例真菌血症患者抗真菌治疗后,3例痊愈、1例合并肺部假丝酵母菌感染治疗无效死亡。结论肿瘤患者CVC相关真菌感染的主要病原菌是近平滑假丝酵母菌,及时拔除CVC,可有效地预防导管相关性血行感染。
OBJECTIVE To explore the incidence,etiology,and risk factors of central venous catheter（CVC）-related fungal infections in tumor patients so as to propose the effective prevention measures.METHODS The related factors for infections in 200 tumor patients who underwent CVC from Jan to Oct,2011 were reviewed retrospectively.RESULTS The incidence of CVC-related fungal infections was 15.0%.There were 26 cases with single CVC-related infections and 4 cases with fungemia.Candida parapsilosis,Candida tropicalis,Candida ruffle monilia,Candida albicans,and Candida glabrata accounted for 53.3%,16.7%,13.3%,10.0% and 6.7%,respectively.The gender,age,types of tumor,and surgery were negatively correlated with the incidence of CVC-related infections,the difference in the infection rates between the different sites of catheterization was statistically significant（P0.05）,the difference in the catheterization duration between the patients with CVC-related infections was statistically significant（P0.05）,totally 26 cases with infections were cured after extubation of CVC,3 of 4 patients with fungemia were cured after the antifungal treatment,and 1 case died of the mixed pulmonary Candida infections.CONCLUSION Candida parapsilosis is the predominant pathogen causing CVC-related fungal infections in the tumor patients.Timely extubation of CVC can effectively prevent catheter-related blood stream infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第3期514-516,共3页
Chinese Journal of Nosocomiology
关键词
中心静脉导管
肿瘤
真菌
感染
Central venous catheter-related infections
Tumor
Fungi
Infection
