综合ICU院内肺部真菌感染临床分析

Pulmonary Fungal Nosocomial Infection in Comprehensive ICU:A Clinical Analysis

目的调查综合重症监护病房(综合ICU)院内肺部真菌感染的临床状况并提出防治措施。方法回顾分析2003年5月-2008年5月82例院内肺部真菌感染患者的临床资料。结果院内肺部真菌感染的发生率在ICU为9.8%,假丝酵母菌属占59.6%,主要表现有大量白色淡黄稀痰,诱发因素主要有病情危重、气道开放、不合理使用广谱抗菌药物、长期使用激素、侵入性治疗等,氟康唑、两性霉素B、伏立康唑疗效好。结论应重视消除诱发因素、早期诊断和经验治疗。

OBJECTIVE To analyze the susceptible factors to offer prevention and treatment of nosocomial pulmonary fungal infection in comprehensive ICU. METHODS The clinical materials of 82 patients with pulmonary fungal nosocomial infection in our department from May 2003 to May 2008 were reviewed. RESULTS The infection rate of total 836 patients was 9.81%. Candidiasis was the most frequent type in fungal infection, 59.7% of which were due to Candida. The most clinical features were a large amount of light yellow sputum after tracheotomy and intratracheal indwelling eannula. The factors related to pulmonary fungal nosocomial infection were the severity of the underlying disease, tracheal intubations, broadspeetrum antibiotics abuse, long-term use of glucocorticoid, interventional treatment, etc. Fluconazole, amphotericin B and voriconazole had better clinical effects on treatment of fungal infection than other antifungal drugs. CONCLUSIONS It＇s important to eliminate the susceptible factors and to provide the early diagnosis and experimental treatment.