2011年与2017年某综合医院院内深部真菌感染状况比较

A comparative analysis for nosocomial deep fungal infections cases in a tertiary hospital between 2011 and 2017

目的了解综合医院院内深部真菌感染变化动态,为深部真菌感染诊治提供参考。方法对某院2011年2月至5月和2017年2月至5月住院病例,采集相关信息进行回顾性分析。结果①2011年2月至5月住院患者22185例,诊断为深部真菌感染160例,占住院总病例的0.72%,2017年相同时间段住院患者33033例,诊断为深部真菌感染688例,占住院病例2.08%。2011年与2017年相同时间段深部真菌感染率有统计学差异(P<0.001),2017年感染率明显高于2011年。②2011年与2017年不同年龄段深部真菌感染率存在差异,2017年(81~90)岁、(91~100)岁两个年龄段感染率显著高于2011年,且出现了(0~10)岁深部真菌感染病例,2017年(30~80)岁年龄段深部真菌感染率构成比则低于2011年。③2017年2月至5月所分离的菌株数明显高于2011年相同时间,菌种无明显变化,均以念珠菌感染为主,但2017年有部分病例相同部位同一标本同时培养出两种或两种以上念珠菌。④与2011年相比,2017年深部真菌感染患者死亡率明显下降(P<0.05);随着危险因素增加,深部真菌感染患者死亡率升高。结论2017年深部真菌感染率较2011年明显升高,(81~90)岁、(91~100)岁两个年龄段感染率也显著高于2011年,并出现了(0~10)岁深部真菌感染者;2017年深部真菌感染死亡率较2011年明显下降,两个年度深部真菌感染者菌种无明显变化,均以念珠菌感染为主;预后因素分析表明,危险因素越多,真菌感染患者的死亡概率越大。

Objective The situation of nosocomial deep fungal infections in 2011 and 2017 was compared to provide reference for diagnosis and treatment of deep fungal infections in hospital.Methods Retrospective analysis was conducted on the inpatient cases from February to May 2011 and the same time in 2017 in our hospital,and relevant information were collected for statistical comparative analysis.Results①There were 160 cases of deep fungal infection from February to May 2011,accounting for 0.72% of the total number of inpatients.And there were 688 cases in February to May in 2017,accounting for 2.08%.There was significant difference in the infection rate of deep fungal infections between 2011 and 2017(P<0.001).The infection rate in 2017 was significantly higher than that in 2011.②There were differences in deep fungal infection rates among different age groups between 2011 and 2017.The infection rates of(81〜90)years old and(91〜100)years old in 2017 were significantly higher than those in 2011.And there were deep fungal infections of(0〜10)years old in 2017.The composition ratio of deep fungal infections of(30〜80)years old in 2017 was lower than that in 2011.③The isolates isolated from February to May in 2017 were significantly more than those in 2011.At the same time,there was no significant change in composition of species which were mainly Candida infections.Two or more Candida species were cultured from the same specimen at the same site in some cases in 2017.④The mortality was decreased in 2017.The patient's prognosis is closely correlated to the total number of risk factors in patients with deep fungal infection(P<0.05).As the total number of risk factors increases,the patient's mortality rate increases.Conclusions The infection rate of deep fungal infections in 2017 was significantly higher than that in 2011.The proportion of the age groups including(81〜90)years old age and(91〜100)years old age in deep fungal infections was also significantly higher than that in 2011.And patients with deep fungal infections had been found in(0〜10)years old age group in 2017.The annual mortality rate of deep fungal infections was significantly lower in 2017 than that in 2011.There was seldom difference of pathogenic fungi species distribution between these two years,Candida species is the main pathogens.The more risk factors,the higher the mortality of patients are.