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ICU呼吸机相关性肺炎患者痰液真菌阳性的临床研究 被引量:8

Clinical significance of positive sputum culture of fungi in ICU patients with ventilator-associated pneumonia
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摘要 目的研究综合重症监护病房(ICU)中临床诊断为呼吸机相关性肺炎(VAP)患者痰液培养真菌阳性在VAP患者中的临床意义,为合理使用抗菌药物提供参考依据。方法选择2012年4月-2014年4月ICU临床诊断为呼吸机相关性肺炎的142例患者为研究对象,按痰培养结果分为真菌阳性组77例和真菌阴性组65例,比较两组患者的通气时间及病死率等,数据采用SPSS 13.0软件进行统计分析。结果 142例患者共培养出病原菌394株,其中真菌检出126株,占32.0%;在142例临床诊断的VAP患者中真菌阳性77例占54.2%;患者真菌感染与其年龄及伴有呼吸系统疾病相关(P<0.05);真菌阳性组及真菌阴性组患者的机械通气时间分别为(363±85)h和(300±67)h,患者病死率分别为39.0%、43.1%,两组间差异无统计学意义。结论呼吸机相关性肺炎患者痰培养真菌阳性率高,与其年龄及伴有呼吸系统疾病相关。 OBJECTIVE To explore the clinical significance of positive sputum culture of fungi in comprehensive in‐tensive care unit (ICU) patients clinically diagnosed as ventilator‐associated pneumonia (VAP) so as to provide guidance for reasonable use of antibiotics .METHODS A total of 142 patients who were clinically diagnosed as VAP and treated in the ICU from Apr 2012 to Apr 2014 were recruited as the study objects and were divided into the positive fungi group with 77 cases and the negative fungi group with 65 cases according to the results of spu‐tum culture .The duration of ventilation and the mortality rate were observed and compared between the two groups of patients ,and the statistical analysis was performed with the use of SPSS 13 .0 software .RESULTS To‐tally 394 strains of pathogens have been cultured from the 142 patients ,of which 32 .0% (126 strains ) were fun‐gi .Of the 142 patients clinically diagnosed as VAP ,77 were tested positive for the fungi ,accounting for 54 .2% . The incidence of the fungal infections was associated with the age and respiratory system disease (P〈0 .05) .The mechanical ventilation duration of the positive fungi group was (363 &#177; 85)hour ,the negative fungi group (300 &#177; 67)hours ;the mortality rate of the positive fungi group was 39 .0% ,the negative fungi group 43 .1% ,and there was no significant difference between the two groups .CONCLUSION The positive rate of sputum culture of fungi is high in the patents with VAP ,which is associated with the age and respiratory system disease .
出处 《中华医院感染学杂志》 CAS CSCD 北大核心 2015年第16期3650-3652,共3页 Chinese Journal of Nosocomiology
基金 湖北省自然科学基金资助项目(2014CFB962)
关键词 呼吸机相关性肺炎 真菌 抗真菌治疗 Ventilation-associated pneumonia Fungus Anti-fungal therapy
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参考文献4

  • 1Kollef MH,Ward S.The influence of mini-BAL cultures on patient outcomes:implications for the antibiotic management of ventilator-associated pneumonia[J].Chest,1998,113(2):412-420.
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  • 3Williamson DR,Albert M,Perreault MM,et al.The relationship between Candida species cultured from the respiratory tract and systemic inflammation in critically ill patients with ventilator-associated pneumonia[J].Can J Anaesth,2011,58(3):275-284.
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