慢性肾脏病并发医院真菌感染的易感因素和真菌特点分析

Clinical analysis on predisposing factors and fungal characteristics of nosocomial fungal infection in patients with chronic kidney disease

目的探讨慢性肾脏病(CKD)并发医院真菌感染(NFI)情况及其易感因素。方法评价CKD并发NFI的真菌特征和实验室指标与NFI的关系。结果65例CKD并发NFI者中最常见的感染部位是泌尿道25例次(38.46%),其次是消化道20例次(30.77%);最常见的病原菌是白色念珠菌50例次(68.49%),其次是热带念珠菌13例次(17.81%);白色念珠菌对氟康唑的敏感率为90%。易感因素有住院时间长、贫血、营养不良、低IgG血症、大量蛋白尿、肾功能不全、大剂量使用激素、环磷酰胺和广谱抗生素等。结论CKD易并发NFI,最常见的病原菌是白色念珠菌,控制易感因素是预防NFI的有效方法。

Objective To investigate the predisposing factors and fungal characteristics of noso- comial fungal infection （NFI） in patients with chronic kidney disease （CKD）. Methods The fungal characteristics and laboratory indices were analyzed in patients with and without NFI secondary to CKD. Results The most common infection site of NFI in 65 cases patients with CKD was urinary tract （25 man--times, 38.46%）, and the second common site was digestive tract （20 man--times, 30. 77%）. The most common pathogenic fungus was Candida albicans （68.49%）, followed by Candida tropicalis （17.81%）. The sensitivity of Candida albieans to fluconazol was 90%. The predisposing factors included prolonged length of stay, anaemia, malnutrition, hypogammaglobulinemia, mass pro- teinuria, renal insufficiency, and the use of large dose of broad spectrum antibiotics, prednisone and cytoxan. Conclusion CKD may predispose to NFI, and the most common fungus is Candida albicans, so the predisposing factors should be controlled so as to prevent NFI among patients with CKD.