应用呼吸机的儿童真菌感染相关性肺炎的分析

Fungal infections in children with fungal ventilator-associated pneumonia

目的：探讨儿科重症监护病房（PICU）机械通气患儿呼吸机真菌感染相关性肺炎（FVAP）病原真菌的分布情况.方法：对本院儿科26例呼吸机真菌感染相关性肺炎（FVAP）患儿,取痰标本作真菌直接涂片镜检、真菌培养及菌种鉴定.结果：对26例患儿标本均检出真菌,检出菌种6种,其中白色念珠菌15株（57.70%）,热带念珠菌4株（15.40%）,光滑假丝酵母1株（3.85%）,中间假丝酵母1株（3.85%）,克柔念珠菌2株（7.70%）,曲霉菌3株（11.50%）.结论：儿童呼吸机真菌感相关性肺炎（FVAP）的主要病原为白色念珠菌、热带念珠菌及曲霉菌,易感因素和常规的真菌检测指标可作为积极抗真菌治疗的依据.

Objective： To understand the distribution of pathogenic fungi in children with fungal ventilatorassociated pneumonia （FVAP） who have received mechanical ventilation in pediatric intensive care units （PICU）. Method ： Sputum samples were collected from 26 patients with FVAP and subjected to fugal investigations by direct smearing,fugal culture and strain identifications. Results：A total of 6 species of fugus were detected in all samples from the 26 children, including 15 （ 57.7% ） samples found with candida albicans,4 （ 15.40% ） with Candida tropiealis,1 （3.85%） with Candida glabrata,2 （7.70%） with Candida intermedia,2 （7.70%） with Candida krusei and 3 （ 11.50% ） with aspergillus. Conclusion： The major pathogenic fungi among children with FVAP were shown to be candida albicans, eandida tropicalis and Aspergillus. Predisposing factors and conventional detection of fungi can be used to guide anti-fungal treatment.