目的 探討呼吸科病房侵襲性真菌感染( IFI) 的危險因素。方法 對重慶市5 家三甲醫(yī)院呼吸內(nèi)科診斷為真菌感染或呼吸道標本驗出真菌的住院病例進行篩選, 對選出的符合IFI 診斷的病例采用多中心、回顧性、病例對照的研究方法, 進行風險因素回顧性分析。對照組為同期呼吸科住院的非真菌的感染和定植病例。結果 共篩選出IFI 患者34 例, 對照組患者50 例。IFI 組與對照組的年齡、性別無顯著差異( P gt;0. 05) 。IFI 組住院天數(shù)、使用碳青霉烯類抗生素、化療、深靜脈置管、全胃腸外營養(yǎng)( TPN) 、中性粒細胞減少和腎功能損害與對照組有顯著差異。多因素Logistic 回歸分析顯示使用碳青霉烯類抗生素( OR=6. 753) 、深靜脈置管( OR= 5. 021) 、TPN( OR= 3. 199) 是呼吸科病人發(fā)生IFI 的獨立危險因素。結論 碳青霉烯類抗生素、深靜脈置管、TPN 是呼吸科病人發(fā)生IFI 的獨立危險因素。
引用本文： 吳學玲,李學軍,陳虹,王導新,曹官銘,王長征. 重慶市呼吸病房侵襲性真菌感染危險因素的多中心回顧性分析. 中國呼吸與危重監(jiān)護雜志, 2009, 09(6): 544-546. doi: 復制
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- 1. Cuenca EM, Bernal ML, Buitrago MJ, et al. Update on the epidemiology and diagnosis of invasive fungal infection. Int J Antimicrob Agents, 2008, 32: S143-S147.
- 2. Castón-Osorio JJ, Rivero A, Torre-Cisneros J. Epidemiology of invasive fungal infection. Int J Antimicrob Agents, 2008 , 32: S103 -S109.
- 3. vallés J, Mesalles E, Mariscal D, et al. A 7-year study of severe hospital-acquired pneumonia requiring ICU admission. Inten Care Med, 2003, 29: 1981-1988.
- 4. 年間醫(yī)院內(nèi)侵襲性真菌感染的病原菌分布及臨床分析. 中華醫(yī)院感染學雜志, 2008, 18: 1030-1033.
- 5. 馮文莉, 楊靜, 奚志琴, 等.
- 6. Ostrosky-Zeichner L, Pappas PG. Invasive candidiasis in the intensive Care Unit. Crit Care Med, 2006 , 34 : 857-863.
- 7. 邵劍峰. 醫(yī)院真菌感染臨床調(diào)查研究. 中華醫(yī)院感染學雜志,2008, 18: 1192-1194.
- 8. 中國侵襲性肺部真菌感染工作組. 侵襲性肺部真菌感染的診斷標準與治療原則( 草案) . 中國實用內(nèi)科雜志, 2006, 26: 1748-1751.
- 9. Charles PE, Daller F, Aube H, et al. Candida spp. colonization significance in critically ill medical patients: a prospective study.Intensive Care Med, 2005, 31: 393-400.
- 10. 陳瑞英, 靳建軍, 歐陽松云, 等. 非中性粒細胞缺乏患者發(fā)生侵襲性曲霉病的危險因素、臨床特征及預后分析. 中國呼吸與危重監(jiān)護雜志, 2008, 7: 169-173.
- 11. Leon C, Ruiz-Santana S, Saaverdra P, et al. A bedside scoring system ( “Candida score”) for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization. Crit Care Med, 2006, 34, 730-737.