69例真菌血症临床回顾性分析

Clinical Retrospective Analysis of 69 Patients with Fungemia

目的对真菌性血液感染常见真菌的菌群分布、耐药性状况及真菌血症临床特征进行分析,为临床诊治提供参考。方法收集2004年1月-2008年12月医院69例真菌血症患者的临床资料进行回顾分析。结果>65%的真菌血症患者患有≥2种的基础疾病,>50.0%患者均有导管留置,而且患者在血培养采样前1周内均不同程度使用抗菌药物;69例真菌血症中,53例(76.8%)与假丝酵母菌属有关,但仅18例由白色假丝酵母菌引起,真菌血症患者的病死率为44.9%;不同假丝酵母菌对抗真菌药物存在不同程度的耐药率。结论真菌血症多发生于基础疾病严重者,由非白色假丝酵母菌导致的败血症在真菌血症中占很大比例;部分真菌对氟康唑、伊曲康唑耐药;应重视对血液真菌感染患者的检测及合理用药,以有效控制病情。

OBJECTIVE To investigate the epidemiology METHODS A retrospective survey was done with the 69 of fungemia and provide evidence for clinical therapy. cases of fungemia in our hospital from Jan 2004 to Dec 2008. RESULTS More than 65% of the patients suffered from two and more underlying diseases. Over a half of infections were developed following placement of catheters. And all of the patients had a history of antimicrobial agents use before blood culture. 53 （76.8%） cases were associated with Candida spp. Only 18 strains were C. albicans. The mortality rate of fungemia was 44.9M. Different Candida species had different resistance rates to antifungal agents. CONCLUSIONS Fungemia patients often have serious underlying diseases. Most fungemia cases are candidemia caused by non-C, albicans. Some fungal pathogens are resistant to fluconazole and itraconazole.