艾滋病患者院内真菌感染现状及防治对策(附1463例报告)

Nosocominal Fungal Infection in AIDS Patients: Prevention,Treatment and Control Measures(Report of 1463 Cases)

目的：调查艾滋病患者院内真菌感染的现状，制定防治对策，预防感染的发生。方法：回顾性分析我院2005～2008年1463例艾滋病院内真菌感染者的临床资料，分析相关因素。结果：1463例占同期出院艾滋病患者的86．98％（1463／1682），占同期医院内感染的96．76％（1463／1512）。真菌感染以口咽部为主，占82．09％（1201／1463）。真菌种类中白色假丝酵母菌属位居首位（71．09％），其次是新型隐球酵母菌（19．07％）。住院时间、高效抗反转录病毒（HAART）治疗、滥用广谱抗生素、侵袭性操作、不规范抗真菌治疗是真菌感染的危险因素。结论：控制真菌感染的危险因素，合理使用抗生素，减少侵入性操作，提高患者机体免疫力，是预防艾滋病患者院内真菌感染的主要措施。

Objective：To investigate the present situation of nosocominal fungal infection among AIDS patients and to suggest preventive and infection control measures. Methods：The clinical data of fungal infection of 1 463 AIDS patients admitted into our hospital during 2005-2008 and the correlative factors were retrospectively analyzed. Results：The 1 463 patients took up 86.98% （ 1 463/1 682） of the AIDS patients diagnosed in the study period and 96.76% （ 1 463/1 512） of patients of nosocominal fungal infection. Oropharyngeal infection was the primary cause,taking up 82.09% （ 1 201/1 463 ） ,with white Candida mycoderma fungus ranking on the top （71.09%）and a new type of yeast fungus ranking next （19.07%）. Hospital-stay time, HAART treatment, broad-spectrum antibiotic abuse,invasive operation,and non-standard anti-fungal treatment were found to be major risk factors of fungal infection. Conclusion： Fungal infection control, proper use of antibiotics, less invasive operations and improvement of the patient＇s immunity are effective preventive and control measures of nosocominal fungal infection in AIDS patients.