维持性血液透析患者并发真菌感染临床分析

Fungal Infection among Patients with Maintenance Hemodialysis:A Clinical Analysis

目的探讨维持性血液透析患者医院获得性真菌感染危险因素、发生特点及防治措施。方法对2002年1月-2006年12月在医院住院128例次维持性血液透析患者临床资料进行回顾性分析。结果感染部位以肺部最常见,占69.4%;假丝酵母菌属是主要的感染病原菌,以白色假丝酵母菌比例最高,占61.1%;原有糖尿病、并存肿瘤及慢性阻塞性肺部疾病、长期反复使用抗菌药物、营养状况差、透析不充分、透析导管留置是维持性透析患者发生真菌感染的危险因素。结论维持性血液透析患者易发生真菌感染,病原菌以白色假丝酵母菌为主,肺部感染发生率较高;积极治疗原发病及并存疾病,严格规范使用抗菌药物,充分透析,积极改善患者营养状况,尽量减少透析导管留置是降低真菌感染发生的关键。

OBJECTIVE To investigate the risk factors, characteristics, measures of prevention and treatment of hospital fungal infection among maintenance hemodialysis patients. METHODS Clinical data of 128 maintenance hemodialysis patients between Jan 2002 and Dec 2006 were enrolled in this retrospective study of hospitalized infection cases. RESULTS During above period, 36 infection episodes of 27 cases were occurred. The major infection site was lungs （69.4 %）. the Candida albicans was the main pathogen species （61.1%）. The underlying and complicating diseases such as diabetes, chronic obstructive pulmonary disease and tumor, long antibiotics using, long hospitalization, poor nutrition status, inadequate hemodialysis, and venous indwelling catheter were the risk factors which led to fungal infection among maintenance hemodialysis patients. CONCLUSIONS The maintenance hemodialysis patients are easy to induce fungal infection. The C. albicans is the main pathogen species. The incidence of underlying diseases is rather high. Treatment of original diseases and complicating diseases, the standard using of antibiotics, adequate hemodialysis, the nutrition status and the reduction of the indwelling time of venous catheter are all the keys to decrease the fungal infection.