医院内非白假丝酵母菌感染的病原学及危险因素研究

Etiology features and risk factors analysis of non-albicans candida infections in hospital

目的 探讨住院患者非白假丝酵母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日至2008年3月31日间住院的256例非白假丝酵母菌感染患者的病原学进行了研究;采用病例对照研究方法,对256例非白假丝酵母菌感染者和1220例无真菌感染者进行对比分析,应用SPSS13.0统计软件分析其发生的危险因素.结果 （1）从不同部位共分离出非白假丝酵母菌256株,以光滑假丝酵母菌38.28%为最多、其次为克柔假丝酵母菌37.11%、近平滑假丝酵母菌12.50%、热带假丝酵母菌9.77%、葡萄牙假丝酵母菌2.34%;（2）老龄化、住院时间过长、白蛋白降低、基础疾病、预防性使用抗真菌药物、广谱抗菌素以及使用有创伤的检查和治疗者容易发生非白假丝酵母菌感染.结论 早期诊治基础疾病、合理规范应用检查和治疗手段、适当缩短住院时间、加强支持治疗是预防非白假丝酵母菌感染的关键.

Objective To investigate the etiology features and relevant risk factors of non-albicans candida infections in hospital. Methods 256 patients of non-albicans candida infections admitted in the second hospital of shanxi medical university from April 2006 to March 2008 were enrolled in this investigation, and a prospective case-control study was executed on 256 cases of non-albicans candida infections and 1220 cases of non-fungal infections. The incidence and risk factors of non-albicans candida infections were analyzed by statistical software SPSS13.0. Results Candida glabrata was the most common reason of non - albicans candida infections （38. 28% ） , followed by candida krusei （37. 11% ）, candida parapsilosis （ 12. 50% ）, candida tropicalis （9. 77% ）, candida lusitaniae （2. 34% ）. Univariate analysis and multivariate logistic regression analysis showed that aging, length of stay, underlying disease, losing albumin, using prophylaxis antifungal drugs, using broad spectrum antibiotics, 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 non-albicans candida infections. Conclusions Non-albicans candida was the main of fungal infections in patients. To efficiently control the disease, it will be helpful by early diagnosis and treatment underlying diseases and commodities and using appropriate tools of examine and treatment methods.