老年患者真菌性医院感染的临床调查

Nosocomial Fungal Infection in Senile Hospitalized Patients:A Clinical Investigation

目的 探讨老年患者真菌性医院感染现状、菌种分布和危险因素 ,以制定有效的防治措施。方法 查阅2 0 0 0年 1月～ 2 0 0 3年 12月 4年中老年患者病案和临床资料 ,以医院感染诊断标准为依据 ,统计并分析资料与数据 ,得出 12 7例老年患者真菌感染病例的有关规律。结果 12 7例老年真菌医院感染患者病原性真菌中占首位的是白色念珠菌 ,为 5 1 2 % ,热带念珠菌次之 ,占 18 9% ;12 7例标本来源以下呼吸道分泌物占比例最多 ,为 6 1 4 % ,其次为尿液标本 ,占 2 5 2 % ;发病率最高的为老年病科 ,其次为ICU、呼吸内科等 ;感染危险因素为侵入性诊疗操作、激素与抗生素的使用等。结论 老年患者真菌感染的防治主要采取的措施有支持疗法 ,提高老年人免疫力、积极治疗原发基础疾病、减少侵入性诊疗手段、合理使用抗生素、在治疗过程中严密监测真菌医院感染的发生等 ,以预防与控制老年患者真菌感染的发生与流行。

OBJECTIVE To investigate clinical status, genera distribution, and risk factors of nosocomial fungal infection in senile hospitalized patients. METHODS Case histories of senile hospitalized patients from Jan 2000 to Apr 2003 were analyzed according to Diagnosis Standard of Nosocomial Infection published by national Ministry of Health. RESULTS Totally 127 cases were got. For causative agents, Candida albicans predominated with 51 2%, and C. tropicalis followed with 18 9%. For specimens, lower respiratory tract secretion predominated with 61 4%, and urine followed with 25 2%. For hospitalized sections, the geriatrics department predominated first, followed by intensive care unit and respiratory department. The risk factors included invasive operations, receiving hormones and antibiotics therapy. CONCLUSIONS To prevent and control fungi nosocomial infection in senile hospitalized patients, measures such as enhancing immunity, curing of underlying diseases, deducing invasive operations, reasonable using of antibiotics, and intensive surveillance should be adopted.