肿瘤患者合并非白念珠菌性血流感染的危险因素分析

Risk factors for complication with non-Candida albicans bloodstream infection in tumor patients

目的分析非白念珠菌性血流感染的流行病学现况及相关危险因素,为临床防治提供依据。方法对2007-2015年医院91例念珠菌性血流感染肿瘤患者病历资料进行回顾性分析。结果 91例念珠菌性血流感染肿瘤患者中白念珠菌性血流感染者49例占53.8%,非白念珠菌感染者42例占46.2%,其中造成非白念珠菌性血流感染的病原菌依次为近平滑念珠菌21株占23.1%,光滑念珠菌8株占8.8%、热带念珠菌7株占7.7%、无名念珠菌和葡萄牙念珠菌各3株占3.3%;念珠菌性血流感染患者30天死亡率为28.6%(白念珠菌为26.5%,非白念珠菌为31.0%);相比白念珠菌,住院天数≥35天,以及肿瘤远处脏器转移是非白念珠菌性血流感染的独立危险因素。结论本研究不仅对念珠菌性血流感染流行病学现况进行了分析,更明确了肿瘤患者合并非白念珠菌性血流感染的独立危险因素,为制定相应的预防及治疗措施提供了理论依据。

OBJECTIVE To investigate the epidemiological characteristics of bloodstream infection caused by nonCandida albicans and analyze the related risk factors so as to provide guidance for clinical prevention and treatment.METHODS A total of 91 tumor patients with Candida bloodstream infection who were treated in hospitals from 2007 to 2015were enrolled in the study,and the medical records of the enrolled patients were retrospectively analyzed.RESULTS Of the 91 tumor patients with Candida bloodstream infection,49（53.8%）had C.albicans bloodstream infection and 42（46.2%）had non-C.albicans infection.The pathogens that resulted in the non-C.albicans bloodstream infection were in turn as follows：C.parapsilosis（21strains,23.1%）,Candida glabrata（8strains,8.8%）,Candida tropicalis（7strains,7.7%）,Candida famata（3strains,3.3%）,and Candida lusitaniae（3strains,3.3%）.The 30-day mortality rate of the patients with Candida bloodstream infection was28.6%,the patients with C.albicans bloodstream infection 26.5%,the patients with non-C.albicans infection31.0%.As compared with the C.albicans bloodstream infection,the hospitalization duration more than 35 days and tumor distant organ metastasis were the independent risk factors for the non-C.albicans infection.CONCLUSION This study not only interprets the epidemiological characteristics of the Candidabloodstream infection but also defines the independent risk factors for the complication with non-C.albicans bloodstream infection in the tumor patients,which provides theoretical basis for formulating corresponding prevention and treatment measures.