摘要
背景 : 近年来 ,随着广谱抗生素的应用及危重病人的增多 ,深部真菌日益成为医院内感染的主要病原菌之一。在深部真菌感染中念珠菌感染又占其中的大部分。为了更好的预防和治疗院内深部念珠菌感染 ,我们对本院该菌的感染进行了菌种类型调查和危险因素分析。目的 : 研究本院深部念珠菌感染的危险因素及菌种类型分布。方法 : 对北京医科大学第一医院从 1998年 6月至 1999年 12月住院和急诊留观病人不同部位念珠菌培养阳性的临床标本进行致病菌种调查。同时从中选取了 15 0例病人进行危险因素的评价。结果 : (1)在我院 1年半的时间内共有 5 95份念珠菌培养阳性的临床标本 ,其中白念珠菌为主要的病原菌 ,占 72 .6 %。以后依次为热带念珠菌、光滑念珠菌和近平滑念珠菌 ;(2 )在深部念珠菌感染中 ,89.3%的患者长期应用广谱抗生素 ,2 0 %以上的患者存在应用激素治疗 ,合并恶性肿瘤 ,外科手术以及合并糖尿病的危险因素 ;(3)在血培养阳性 8例病人中 ,4例应用了中央静脉插管 ;(4 ) 30例尿培养阳性的患者 ,86 .6 %长期应用广谱抗生素 ,5 6 .7%应用尿管。结论 : (1)我院的院内深部念珠菌感染 ,白念珠菌为首要致病菌 ;(2 )长期应用广谱抗生素是院内深部念珠菌感染最常见的危险因素。应用激素治疗 。
Background:In recent years, advances in medical and surgical therapy have lead to the proliferation of severely ill, immunocompromised, hospitalized patient population. These immunocompromised patients are highly susceptible to nosocomial infections caused by fungi. The majority of nosocomial fungi infections are caused by Candida species. In order to prevent and cure the invasive Candida infection, it is necessary to study the risk factors and the species distribution of the disease. Objective:Analysis on species distribution and risk factors of nosocomial invasive Candida infection. Methods:The culture positive specimen collected from blood, sputum, urine, stool, thoracic fluid , peritoneal fluid , as well as broncho alveolar lavage (BAL) from June. 1998 to December, 1999 were investigated. We analyzed the risk factors of 150 patients who had the invasive Candida infection.Results:(1)The total number of the strains was 595. Among them, Candida albicans accounted for 72.6%. It was followed by Candida tropicalis, Candida parapsilosis and Candida glabrata; (2)89.3% of patients were administrated by broad spectrum antibiotics for long time. Corticosteroid therapy, surgery, malignant tumor and diabetes mellitus were all accounted for more than 20%; (3)Eight patients were candidemia. Among them, 4 patients had central venous catheter; (4)In the patients with candiduria, antibiotics therapy and urinary catheters were accounted for 86.6% and 56.7% respectively. Conclusions :(1)Candida albicans was the major pathogen in our hospital during 1.5 years; (2)Major risk factor for invasive candida infections was administration of broad spectrum antibiotics. Corticosteroid therapy, surgery, malignant tumor and diabetes mellitus were other important risk factors; (3)Candidemia was related with the indwelling central venous catheter; (4)The candiduria is related with antibiotics therapy and urinary catheters. [
出处
《中国麻风皮肤病杂志》
北大核心
2000年第4期211-215,共5页
China Journal of Leprosy and Skin Diseases
基金
卫生部重点学科资助
关键词
院内深部念珠菌感染
危险因素
菌种类型
nosocomial Candida infections
risk factors
species distribution
