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目的:探讨肠道发生真菌医源性感染的病原种类、相关危险因素,为临床有效预防医源性感染提供参考依据。方法:回顾性调查我院2010年1月至2012年10月发生的肠道真菌医源性感染153例,调查患者的一般资料、治疗方法、用药方案、易感因素、感染的病原菌等相关因素,采用单因素方差分析和多因素Logistic回归分析各因素对肠道真菌感染的危险性。结果:153例患者共检出137株真菌,其中白色念珠菌76株,占55.47%。单因素分析结果显示:年老、长时间联用多种抗菌药物、使用三代头孢菌素和糖皮质激素、营养不良以及基础疾病较严重是发生肠道真菌医源性感染的危险因素(P<0.05),Logistic分析结果显示:联用两种以上抗生素(β=1.879,OR=6.545)、使用三代头孢菌素(β=3.239,OR=25.520)、使用糖皮质激素(β=2.402,OR=11.047)以及严重的基础疾病(β=2.420,OR=11.242)与肠道发生医源性真菌感染密切相关。结论:白色念珠菌是肠道真菌感染的主要致病菌,高龄、不合理应用抗生素和激素以及严重的基础疾病是肠道发生真菌医源性感染的危险因素。
Objective: To explore the pathogenic species and related risk factors of iatrogenic fungal infection in gut, and provide reference for clinical prevention of iatrogenic infection. Methods: A retrospective survey of 153 cases of enteric fungal iatrogenic infection in our hospital from January 2010 to October 2012 was carried out to investigate the general information, treatment methods, medication regimens, susceptibility factors, pathogenic bacteria and other related factors , Using single factor analysis of variance and multivariate Logistic regression analysis of various factors on the risk of intestinal fungal infection. Results: A total of 137 strains of fungi were detected in 153 patients, 76 strains of Candida albicans, accounting for 55.47%. Univariate analysis showed that the combined use of multiple antibacterials, the third generation cephalosporins and glucocorticoids, malnutrition and more serious underlying diseases were the risk factors of iatrogenic iatrogenic infection (P < Logistic analysis showed that the combination of two or more antibiotics (β = 1.879, OR = 6.545), third generation cephalosporins (β = 3.239, OR = 25.520) and glucocorticoid (β = 2.402, OR = 11.047) and severe underlying diseases (β = 2.420, OR = 11.242) were closely related to intestinal iatrogenic fungal infections. Conclusion: Candida albicans is the main pathogen of intestinal fungal infection. Older age, unreasonable use of antibiotics and hormones and serious underlying diseases are risk factors for iatrogenic fungal infections.