中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2010年
19期
6-9
,共4页
黄磊%赵令玺%张卫星%罗华%陈映群%张声
黃磊%趙令璽%張衛星%囉華%陳映群%張聲
황뢰%조령새%장위성%라화%진영군%장성
念珠菌,白色%危险因素%重症监护病房
唸珠菌,白色%危險因素%重癥鑑護病房
념주균,백색%위험인소%중증감호병방
Candida albicans%Risk factors%Intensive care units
目的 研究重症监护病房(ICU)患者非白色念珠菌和白色念珠菌感染危险因素的差异.方法 回顾性分析2003年2月至2009年4月ICU获得性念珠菌感染患者103例,其中非白色念珠菌感染46例,白色念珠菌感染57例,对其多个危险因素进行统计学分析.结果 非白色念珠菌中,光滑念珠菌19例(18.4%),近平滑念珠菌13例(12.6%),热带念珠菌10例(9.7%),克柔念珠菌2例(1.9%),其他念珠菌2例(1.9%).经Logistic多因素回归分析发现,中心静脉导管(CVC)留置>2 d(OR=32.477,95%可信区间:4.905～215.035,P=0.000)、全胃肠外营养(OR=3.119,95%可信区间:1.214～8.015,P=0.018)和氟康唑预防治疗(OR=5.084,95%可信区间:1.319～19.596,P=0.018)与非白色念珠菌感染密切相关.结论 CVC留置>2 d、全胃肠外营养和氟康唑预防治疗是非白色念珠菌感染的独立危险因素,可用于指导经验性抗真菌治疗的药物选择.
目的 研究重癥鑑護病房(ICU)患者非白色唸珠菌和白色唸珠菌感染危險因素的差異.方法 迴顧性分析2003年2月至2009年4月ICU穫得性唸珠菌感染患者103例,其中非白色唸珠菌感染46例,白色唸珠菌感染57例,對其多箇危險因素進行統計學分析.結果 非白色唸珠菌中,光滑唸珠菌19例(18.4%),近平滑唸珠菌13例(12.6%),熱帶唸珠菌10例(9.7%),剋柔唸珠菌2例(1.9%),其他唸珠菌2例(1.9%).經Logistic多因素迴歸分析髮現,中心靜脈導管(CVC)留置>2 d(OR=32.477,95%可信區間:4.905～215.035,P=0.000)、全胃腸外營養(OR=3.119,95%可信區間:1.214～8.015,P=0.018)和氟康唑預防治療(OR=5.084,95%可信區間:1.319～19.596,P=0.018)與非白色唸珠菌感染密切相關.結論 CVC留置>2 d、全胃腸外營養和氟康唑預防治療是非白色唸珠菌感染的獨立危險因素,可用于指導經驗性抗真菌治療的藥物選擇.
목적 연구중증감호병방(ICU)환자비백색념주균화백색념주균감염위험인소적차이.방법 회고성분석2003년2월지2009년4월ICU획득성념주균감염환자103례,기중비백색념주균감염46례,백색념주균감염57례,대기다개위험인소진행통계학분석.결과 비백색념주균중,광활념주균19례(18.4%),근평활념주균13례(12.6%),열대념주균10례(9.7%),극유념주균2례(1.9%),기타념주균2례(1.9%).경Logistic다인소회귀분석발현,중심정맥도관(CVC)류치>2 d(OR=32.477,95%가신구간:4.905～215.035,P=0.000)、전위장외영양(OR=3.119,95%가신구간:1.214～8.015,P=0.018)화불강서예방치료(OR=5.084,95%가신구간:1.319～19.596,P=0.018)여비백색념주균감염밀절상관.결론 CVC류치>2 d、전위장외영양화불강서예방치료시비백색념주균감염적독립위험인소,가용우지도경험성항진균치료적약물선택.
Objective To determine the differences of risk factors for non-albicans candida and candida albicans infections among patients in the intensive care unit (ICU). Methods One hundred and three patients with ICU-acquired candida infections were retrospectively analyzed from February 2003 to April 2009. These patients were divided into non-albicans candida species group and candida albicans group.Multiple risk factors were analyzed between two groups. Results Of these patients, 46 patients (44.7%)had infections of non-albicans candida species and 57 patients (55.3%) had candida albicans infection.Among non-albicans candida species, candida glabrata, candida parapsilosis, candida tropicalis, candida krusei and others candida accounted for 19 patients (18.4%), 13 patients (12.6%), 10 patients (9.7%), 2 patients (1.9%) and 2 patients ( 1.9% ), respectively. Multivariate Logistic regression models revealed that central venous catheter (CVC) insertion time > 2 d (OR = 32.477,95% CI:4.905-215.035,P=0.000),total parenteral nutrition (OR =3.119,95% CI:1.214-8.015,P =0.018) and fluconazole prophylaxis therapy (OR = 5.084,95%CI: 1.319-19.596,P = 0.018) were highly correlated with non-albicans candida species infections. Conclusion CVC insertion time > 2 d, total parenteral nutrition and fluconazole prophylaxis therapy are independent risk factors of non-albicans candida species infections and can be used in empirical antifungal therapy.
