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目的探讨念珠菌败血症患者临床特征,病原菌的构成和防治策略。方法回顾性分析2011年8月-2016年7月医院内念珠菌败血症病例,分析患者的易感因素、病原学特点及治疗效果。结果患者一般有3种及3种以上易感因素,主要是低蛋白血症、使用广谱抗菌药物、深静脉置管等。念珠菌血培养阳性时间自入院起(30.3±28.4)d,白色念珠菌(7,46.7%)为主要检出念珠菌。氟康唑和卡泊芬净为主要治疗药物,总病死率为28.6%。结论念珠菌败血症多发生在具有多种易感因素者,特别是有血管内置管和低蛋白血症者。对高危患者应消除易感因素,及时合理选用抗真菌药物以改善预后。
Objective To investigate the clinical characteristics of Candida septicemia patients, the composition of pathogens and prevention and treatment strategies. Methods A retrospective analysis of patients with Candida septicemia in hospital from August 2011 to July 2016 was conducted to analyze the patients’ susceptibility factors, etiological characteristics and therapeutic effect. Results Patients generally have 3 and more than 3 kinds of predisposing factors, mainly hypoproteinemia, the use of broad-spectrum antibiotics, deep vein catheterization. Candida blood culture positive time from admission (30.3 ± 28.4) d, Candida albicans (7,46.7%) as the main detection of Candida. Fluconazole and caspofungin as the main treatment, the total case fatality rate was 28.6%. Conclusions Candida septicemia occurs in patients with multiple predisposing factors, especially those with intravascular and hypoproteinemia. High-risk patients should eliminate the predisposing factors, the timely and rational use of anti-fungal drugs to improve the prognosis.