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目的了解院内深部真菌感染高危患者体内念珠菌的分离情况以及深部念珠菌感染发生的危险因素。方法采用前瞻性队列研究方法对血液科、老年科和 ICU 病房2004年5月至2005年4月入院的所有患者进行各种可能危险因素及深部念珠菌感染的监测。对出现深部念珠菌感染的患者和未出现深部念珠菌感染的患者进行比较,统计学分析采用非条件 Logistic 回归模型,分析深部念珠菌感染发生的危险因素。结果共入组440例患者,其中152例分离到426株念珠菌,白念珠菌占67.4%,其他念珠菌为32.6%。共61例患者出现定植,主要为白念珠菌。对资料完整的193例患者进行危险因素的多因素分析显示2种及2种以上广谱抗生素应用(OR=16.204;95%可信区间:2.005～130.980),念珠菌菌落定植(OR=10.636;95%可信区间:3.743～30.222)和应用尿管(OR=4.285;95%可信区间:1.399～13.127)是深部念珠菌感染发生的危险因素。结论深部真菌感染高危患者体内分离的念珠菌中白念珠菌仍居首位。深部念珠菌感染发生的危险因素依次为2种及2种以上广谱抗生素应用、念珠菌菌落定植和应用尿管。
Objective To investigate the isolation of candida in high-risk patients with deep fungal infection in hospital and the risk factors of deep Candida infection. Methods A prospective cohort study was conducted to monitor all possible risk factors and deep Candida infections in all patients admitted to the Department of Hematology, Geriatrics and ICU wards from May 2004 to April 2005. Patients with deep Candida infection were compared with those without deep Candida infection. Statistical analysis was performed using non-conditional Logistic regression model to analyze the risk factors for deep Candida infection. Results A total of 440 patients were enrolled. Among them, 426 Candida albicans isolates were isolated from 152 patients, Candida albicans accounted for 67.4%, and Candida albicans was 32.6%. A total of 61 patients colonization, mainly Candida albicans. Multivariate analysis of risk factors among 193 patients with complete data showed that two or more broad-spectrum antibiotics (OR = 16.204; 95% confidence interval: 2.005-130.980) and colonies with Candida colonization (OR = 10.636; 95% CI: 3.743-30.222), and catheterization (OR = 4.285; 95% confidence interval: 1.399-13.13) were risk factors for deep Candida infection. Conclusion Candida albicans in Candida isolated from high-risk patients with deep fungal infection still ranks first. The risk factors of deep Candida infection were followed by two kinds and two kinds of broad-spectrum antibiotics application, Candida colonization and application of catheter.