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目的探讨院内获得性真菌败血症的患者科室分布、感染危险因素、病原菌分布和治疗转归。方法回顾性分析2004年1月至2009年1月37例经血培养和临床资料确诊的念珠菌血症的临床资料进行分析。调查念珠菌血症患者的科室分布、病原菌分布、感染危险因素、治疗转归。结果念珠菌血症占5年间所有诊断院内败血症的6.12%,患者均有严重基础疾病和多种危险因素;念珠菌血症的科室分布特点:主要来自综合ICU占51.35%,其余来自胸腹外科、呼吸科、血液科、肿瘤科。病原菌分布以白色假丝酵母菌为主,其次为热带念珠菌、近平滑念珠菌。转归:治愈16例,死亡21例,死亡率56.75%。结论院内获得性念珠菌血症病原菌主要发生在监护病房,病原菌分布主要为白色假丝酵母菌,危险因素主要是留置住院时间长、入住ICU、深静脉置管、机械通气、腹部大手术、多种广谱抗生素长期应用,念珠菌血症病死率高。
Objective To investigate the distribution of departments, the risk factors of infection, the distribution of pathogens and the outcome of treatment in patients with nosocomial fungal sepsis. Methods The clinical data of 37 cases of candidaemia confirmed by menstrual blood culture and clinical data from January 2004 to January 2009 were analyzed retrospectively. Investigate the department of candidaemia patients distribution, distribution of pathogens, risk factors for infection, treatment outcome. Results Candidal bacteremia accounted for 6.12% of all inpatients with sepsis within 5 years. All patients had severe underlying diseases and multiple risk factors. The distribution of candidaemia was mainly from ICU accounting for 51.35% and the rest were from chest and abdomen surgery , Respiratory, Hematology, Oncology. Candida albicans was the main pathogen, followed by Candida tropicalis, Candida glabrata. Outcomes: 16 cases were cured, 21 died, the mortality rate was 56.75%. Conclusions The pathogenic bacteria of acquired candidal bacteremia mainly occurred in the intensive care unit. The main pathogens were Candida albicans. The main risk factors were indwelling hospital stay, ICU admission, deep vein catheterization, mechanical ventilation, major abdominal surgery and many more Long-term use of broad-spectrum antibiotics, candidiasis high mortality.