肺部白色念珠菌与非白色念珠菌感染危险因素的比较

Risk factors for pulmonary fungous infection caused by candida albicans versus non-albicans candida species

目的探讨肺部白色念珠菌与非白色念珠菌感染危险因素的差异。方法对近5年我院176例侵袭性肺部真菌感染病例进行回顾性分析。结果176例患者感染白色念珠菌120株（60．3％），非白色念珠菌79株（39．7％）。除神经系统疾病分布倾向于非白色念珠菌组外，其他各系统疾病两组间分布比较无明显差异。年龄≥65岁患者趋向于感染白色念珠菌，年龄〈65岁，入住ICU，接受各种医源性操作（气管插管／切开，机械通气，留置导尿管）的患者则趋向于感染非白色念珠菌。年龄≥65岁为白色念珠菌感染的独立危险因素，非白色念珠菌感染的危险因素为留置导尿管。结论肺部白色念珠菌与非白色念珠菌感染危险因素的不同，有助于预防性抗真菌治疗药物的选择。

Objective This study we sought to identify differences in risk factors of invasive pulmonary fungous infection caused by Candida albicans and non-albicans candida species. Methods A retrospective chart review was conduct which including 176 patients with invasive pulmonary fungous infection during 2003-2005 in Wuhan Union Hospital. Results There were 176 patients to be infected with 120 strains of Candida albicans （60.3%） and 79 strains of non-albicans candida（39.7% ）. Except the nervous system disease ,there was no significant different distribution of other underlaying diseases between the two groups. Patients whose age ≥ 65 years were more likely to be infected with Candida albicans, while age 〈 65years,in the intensive unit care and accept iatrogenic operations（tracheal intubation/incision, anical ventilation, urethral catheter in） were more likely to have non-albicans candida species infection. Multiple regression analysis showed the significant risk factor for Candida albicans was age≥65 years,and urethral catheter in was the significant risk factor for non-albicans candida species. Conclution The different in the risk factors between Candida albicans and non-albicans candida species may provide help to initiate empiric therapy.