真菌诱发医院感染的检验诊断与临床意义

Analysis of the diagnosis and clinical significance of the nosocomial infection induced by fungi

目的探讨医院感染的诱发因素,研究真菌引起的医院感染的检验诊断并探讨其临床意义,以达到临床合理用药提高患者治愈率。方法回顾性分析由真菌诱发医院感染的148例患者资料,根据其在治疗时是否立即进行真菌检测并根据药敏试验结果进行针对性使用抗菌药物分为观察组(86例)和对照组(62例),观察组为针对性使用抗菌药物治疗,对照组患者根据临床经验选择广谱抗菌药物治疗;观察各组患者治疗后的体温恢复时间、痰液咳出、住院时间以及临床疗效。结果患者治疗后体温恢复时间观察组为(3.2±1.1)d、对照组为(5.5±1.7)d;住院时间观察组为(7.5±2.1)d、对照组为(11.9±2.6)d;治疗后无痰率观察组为91.9%,对照组为69.4%,治愈率观察组为89.5%、对照组为75.8%,两组各项指标比较,差异均有统计学意义(P<0.05)。结论临床对于真菌引起的医院感染患者尽早进行真菌检测并根据药敏分析结果针对性用药,有助于提高感染患者的治愈率,使患者早日康复。

OBJECTIVE To investigate and discuss the diagnosis and clinical significance of the nosocomial infection induced by fungi, and to explore its related factors in order to achieve rational clinical drug use and improve the cure rate of infection. METHODS A retrospective analysis was conducted on the clinical data of 148 patients with nosocomial infection induced by fungi in our hospital. According to the fungi detection right after treatment and the targeted use of antimierobial drugs based on the results of drug sensitivity tests, the patients were divided into observation group （86 cases） and control group （62 cases）. The patients in observation group were treated with specific antimicrobial drugs, while in the control group were treated with broad-spectrum antimicrobial drugs based on clinical experience. The temperature recovery time, sputum expectoration, hospitalization time and clini-cal efficacy of both groups were observed. RESULTS The body temperature recovery time was （ 3.2 ±1.1） days in the observation group, in the control group was （5.5±1. 7） days; the hospitalization time was （7.5±2.1） days in the observation group, while in the control group was （11.9±2.6） days. The non sputum rate was 91.9% in the observation group, while 69.4% in control group, the cure rate was 89.5% in the observation group, 75.8% in the control group, the differences between each indicator in the two groups had statistical significance （P〈0.05）. CONCLUSION Early detection of fungi, and the targeted medication according to the drug sensitivity analysis results, is helpful to improve the cure rate of infection in patients with nosocomial infection induced by fungi.