住院患者念珠菌菌尿的调查

Investigation of candiduria among inpatients

目的调查住院患者念珠菌菌尿的特征。方法回顾性调查分析我院2002—2004年住院患者中尿培养念珠菌阳性者的性别、年龄、基础疾病、抗菌药物应用情况及治疗转归。结果其间53例患者尿培养念珠菌阳性,女性占64.1%,患者患有糖尿病占39.6%。96.2%患者在发现念珠菌菌尿之前使用过抗菌药物。56.6%患者出现过细菌菌尿。念珠菌菌尿中43.4%由白念珠菌引起,56.6%为非白念珠菌所致。出现念珠菌菌尿后有81.1%患者使用了抗真菌药物,氟康唑是最常用的抗真菌药物(占49.1%)。结论患者患有糖尿病和泌尿系统疾病、使用过抗菌药物和尿道插管是住院患者发生念珠菌菌尿的重要诱因,白念珠菌引起的菌尿常见。

Objective To describe the manifestations of candiduria among inpatients. Methods The clinical data of inpatients with candiduria in Bethune International Peace Hospital during 2002 to 2004 were reviewed and analyzed retrospectively,including sex,age,main underlying diseases,antibiotic use,antifungal treatment as well as outcome. Results Fifty-three patients were identified with candiduria during the specified period. Most （64.1%） of these patients were female. Main underlying diseases were diabetes mellitus （39.6%）. Antibiotic use before isolation of Candida in urine was found in 96.2% of the patients. Of these patients,56.6% had previous bacteriuria,35.8% had urinary catheter. The candiduria was due to Candida albicans in 21/53 （43.4%） patients and due to non-albicans in 30/53（56.6%） patients. Antifungal therapy was initiated in 81.1% of the patients after isolation of Candida in urine. Fluconazole （49.1%） was the most frequently prescribed drug. Conclusions Diabetes mellitus,urinary tract disease,antibiotic use and urinary catheter are the most common triggers of candiduria among inpatients. Candiduria is mostly caused by C. albicans.