念珠菌感染的病原学及危险因素研究

Risk factor analysis of Candida infections in hospital

目的:探讨住院患者念珠菌感染的病原学特征以及发生的相关危险因素。方法:对2006年4月1日到2008年3月31日间住院的1170例患者进行念珠菌感染的病原学研究;采用病例对照研究,对1170例念珠菌感染者和1220例无念珠菌感染者进行对比分析,应用SPSS13.0统计软件分析念珠菌感染发生的危险因素。结果:(1)从不同部位共分离出念珠菌1258株,以白念珠菌895株(71.14%)为最多、其次为光滑念珠菌(10.73%)、克柔念珠菌(10.26%)、热带念珠菌(3.42%)、近平滑念珠菌(2.78%)、葡萄牙念珠菌(1.67%);(2)单因素统计学分析结果显示住院患者念珠菌感染由多种因素造成;Logistic多因素回归分析结果显示:性别、年龄、病原菌检测时间、基础疾病、白蛋白值、预防性使用抗念珠菌药物、使用免疫抑制剂以及有创的检查和治疗是住院患者念珠菌感染的独立危险因素。结论:白念珠菌仍为住院患者念珠菌感染的主要病原菌;早期诊治基础疾病、合理规范应用检查和治疗手段是预防念珠菌感染的关键。

Objective：To investigate the etiological features and relevant risk factors of Candida infections in hospital.Methods：1170 patients with Candida infections admitted in the Second Hospital of Shanxi Medical University during April 2006 to March 2008 were enrolled in this investigation,a prospective case-control study during 1170 cases of Candida infections and 1220 cases of non-Candida infections.The incidence and risk factors of Candida infections were analyzed by method of SPSS13.0 model.Results：（1） 1258 cases were isolated from different samples,and Candida albicans 895（71.14%） was the largest,followed by Candida glabrata 10.73%,Candida krusei 10.26%,Candida tropicalis 3.42%,Candida parapsilosis 2.78%,Candida lusitaniae 1.67%.（2） Univariate analysis and multivariate logistic regression analysis showed that sex,age,pathogen detection time,underlying disease,albumin,prophylaxisly antifungal drugs using,immunosuppressants using,invasive examination and treatment（such as total parenteral nutrition（TPN）,invasive procedures,central venous catheters,hemodialysis and mechanical ventilation,et al.） were the independent risk factors for Candida infections.Conclusion：Candida albicans is the main pathogens of Candida infections in patients.To efficiently control the risk factors should be emphasized,including early diagnosis and treatment underlying diseases and comorbidities,appropriate use tools of examine and prudent use methods of treatment.