ICU住院患者各部位真菌定植的情况分析

Analysis the condition of fungal colonization of ICU inpatients

目的分析引起ICU住院患者定植阳性的真菌菌种分布及可能引起真菌定植阳性的部分危险因素，为临床对于可能发生的侵袭性真菌感染的预防和抢先治疗提供理论依据。方法收集2008年9月至2009年2月我院ICU住院75例患者的标本360份，来自咽拭子、肛周拭子、痰或气道吸出物、胃液及尿液，利用VITEK2-Compact鉴定菌种。结果360份标本共分离出定植阳性的真菌101株，12种，其中白色念珠菌60株，占59．4％；胃液中真菌定植阳性的比例最高，为60．0％，尿液最低为6．6％；未发现同一标本中有两种或两种以上定植阳性的真菌，但有9例患者在不同部位出现两种定植阳性的真菌；手术及肠内外营养与胃液真菌定植阳性无明显相关性（P均〉0．05）。结论由白色念珠菌引起的胃液真菌定植阳性在ICU住院患者中最为常见，应提高警惕，及时预防。

Objective To determine the clinical distribution of the fungal colonization positive specimens of ICU inpatients, in combination with other risk factors for fungal colonization to provide the gist for clinical therapy. Methods 360 samples from 750 cases ICU inpatients in our hospital from Sep. 2008 to Feb. 2009 were collected. The isolated fungi from urine, tracheal or sputum, gastric, pharyngeal and perianal swab samples were indentified by VITEK2-Compact. Results Totally 101 strains with 12 species were isolated from 360 samples. The main species of fungi were C.albicans 60 strains （59.4%）. The highest ratio of fungi colonization positive was 60.0% from gastric, and the lowest was 6.6% from urine. There was no the same specimen have two or more fungal colonization positive, however, there were 9 patients existing of two fungi at different parts. There was no significant correlation among operation, total parenteral nntition and enteral nutritional with fungal colonization positive （Pall〉 0.05）. Conclusion Fungal colonization positive of gastric caused by Calbicans is the most common in ICU, which should pay more attention and prevent it timely.