中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2008年
5期
464-468
,共5页
白色念珠菌%念珠菌菌血症%危险因素%重症监护病房
白色唸珠菌%唸珠菌菌血癥%危險因素%重癥鑑護病房
백색념주균%념주균균혈증%위험인소%중증감호병방
Candida albicans%Candidemia%Risk factors%Intensive care unit
目的 探讨重症监护病房(ICU)患者念珠菌菌血症患病现状、变化及病原菌分析.方法 收集2002年4月至2007年3月浙江大学医学院附属第一医院ICU念珠菌菌血症患者临床资料,调查念珠菌菌血症的患病情况及病原菌,进行单因素x2检验及多因素logistic回归分析.结果 5年间ICU出院6034人次,符合念珠菌菌血症的患者75例,年患病率0.67%、1.46%、1.21%、1.15%、1.56%.死亡36例,总病死率48%,年病死率50%、64%、33%、41%、52%.血培养标本分离出念珠菌78株,其中白色念珠菌36株(46.2%),光滑念珠菌17株(21.7%),热带念珠菌14株(17.9%),近平滑念珠菌10株(12.8%),葡萄牙念珠菌1株(1.3%).APACHE Ⅱ评分9～27分,平均17.21分±4.38分.5年间念珠菌菌血症的患病率从0.67%上升到1.56%,非白色念珠菌菌血症患者的比例从50.0%上升至56.5%.经过对白色念珠菌组和非白色念珠菌组各项特征的单因素及多因素logistic回归分析发现,年龄(66岁±14岁 vs.53岁±16岁,P=0.001,OR=1.077,95% CI:1.031～1.124)、低蛋白血症(61.8% vs.81.6%,P=0.033,OR=0.206,95% CI:0.048～0.880)差异有统计学意义.结论 在ICU患者中念珠菌菌血症的患病率有上升趋势,病死率高,非白色念珠菌所致的念珠菌菌血症也有所上升,年龄是发生白色念珠菌感染独立的危险因素,低蛋白血症是非白色念珠菌感染独立的危险因素.
目的 探討重癥鑑護病房(ICU)患者唸珠菌菌血癥患病現狀、變化及病原菌分析.方法 收集2002年4月至2007年3月浙江大學醫學院附屬第一醫院ICU唸珠菌菌血癥患者臨床資料,調查唸珠菌菌血癥的患病情況及病原菌,進行單因素x2檢驗及多因素logistic迴歸分析.結果 5年間ICU齣院6034人次,符閤唸珠菌菌血癥的患者75例,年患病率0.67%、1.46%、1.21%、1.15%、1.56%.死亡36例,總病死率48%,年病死率50%、64%、33%、41%、52%.血培養標本分離齣唸珠菌78株,其中白色唸珠菌36株(46.2%),光滑唸珠菌17株(21.7%),熱帶唸珠菌14株(17.9%),近平滑唸珠菌10株(12.8%),葡萄牙唸珠菌1株(1.3%).APACHE Ⅱ評分9～27分,平均17.21分±4.38分.5年間唸珠菌菌血癥的患病率從0.67%上升到1.56%,非白色唸珠菌菌血癥患者的比例從50.0%上升至56.5%.經過對白色唸珠菌組和非白色唸珠菌組各項特徵的單因素及多因素logistic迴歸分析髮現,年齡(66歲±14歲 vs.53歲±16歲,P=0.001,OR=1.077,95% CI:1.031～1.124)、低蛋白血癥(61.8% vs.81.6%,P=0.033,OR=0.206,95% CI:0.048～0.880)差異有統計學意義.結論 在ICU患者中唸珠菌菌血癥的患病率有上升趨勢,病死率高,非白色唸珠菌所緻的唸珠菌菌血癥也有所上升,年齡是髮生白色唸珠菌感染獨立的危險因素,低蛋白血癥是非白色唸珠菌感染獨立的危險因素.
목적 탐토중증감호병방(ICU)환자념주균균혈증환병현상、변화급병원균분석.방법 수집2002년4월지2007년3월절강대학의학원부속제일의원ICU념주균균혈증환자림상자료,조사념주균균혈증적환병정황급병원균,진행단인소x2검험급다인소logistic회귀분석.결과 5년간ICU출원6034인차,부합념주균균혈증적환자75례,년환병솔0.67%、1.46%、1.21%、1.15%、1.56%.사망36례,총병사솔48%,년병사솔50%、64%、33%、41%、52%.혈배양표본분리출념주균78주,기중백색념주균36주(46.2%),광활념주균17주(21.7%),열대념주균14주(17.9%),근평활념주균10주(12.8%),포도아념주균1주(1.3%).APACHE Ⅱ평분9～27분,평균17.21분±4.38분.5년간념주균균혈증적환병솔종0.67%상승도1.56%,비백색념주균균혈증환자적비례종50.0%상승지56.5%.경과대백색념주균조화비백색념주균조각항특정적단인소급다인소logistic회귀분석발현,년령(66세±14세 vs.53세±16세,P=0.001,OR=1.077,95% CI:1.031～1.124)、저단백혈증(61.8% vs.81.6%,P=0.033,OR=0.206,95% CI:0.048～0.880)차이유통계학의의.결론 재ICU환자중념주균균혈증적환병솔유상승추세,병사솔고,비백색념주균소치적념주균균혈증야유소상승,년령시발생백색념주균감염독립적위험인소,저단백혈증시비백색념주균감염독립적위험인소.
Objective To study the mortality and pathogens of candidemia in patients at hospital intensive care unit(ICU).Methods Clinical data of candidemia cases admitted to ICU of the First Affiliated Hospital of Zhejiang University in recent five years were analyzed retrospectively.Chi-square test and logistic regression analysis were used.Results A total of 6034 patients were discharged in the ICU over the 5-year period.and 75 were diagnosed as candidemia.The annual morbidity rates of candidemia from 2002 to 2006 were 0.67%,1.46%,1.21%,1.15% and 1.56%, respectively.36 cases died of the disease,with the mortality as 48%.The annual mortality rates from 2002 to 2006 were 50%,64%,33%,41% and 52%,respectively.In this period,78 positive blood culture samples strains from ICU were identified as Candida,among which Candida albicans, C.glabrata,C.tropicalis,C.parapsilosis and C.lusitaniae accounted for 46.2%,21.7%,17.9%,12.8% and 1.3%, respectively.Average APACHE Ⅱ scores of the patients with candidemia were 17.21±4.38(range:9-27).During the 5-year period,the annual morbidity of candidemia had increased from 0.67%to 1.56% while the ratios of candidemia due to non-albicans Candida species(NAC)increased from 50.0%to 56.5%.When analyzing the C.albicans group and NAC group with single factor and multiple conditional logistic regression method.we found that age(66±14 vs.53±16,P=0.001,OR=1.077,95% CI:1.031-1.124)and hypoproteinemia(61.8% vs.81.6%, P=0.033,OR=0.206,95%CI:0.048-0.880)both showed statistical significance.Conclusion Candidemia cases in ICU increased gradually and causing higher mortality.The number of patients with candidemia caused by NAC increased in recent 5 year.Age was proved to be a risk factor for those candidemia caused by C.albicans.Hypoproteinemia was proved to be risk factors for the candidemia caused by NAC.
