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目的探讨多发性骨髓瘤(MM)患者医院真菌感染的特点和危险因素。方法对2000年4月-2010年4月219例MM患者医院真菌感染的临床资料进行回顾性分析。结果 58例患者发生74例次医院真菌感染,感染率为26.5%,例次感染率为33.8%;感染部位以呼吸道为主,占91.9%;医院真菌感染呈逐渐上升的趋势;ECOG评分、侵入性操作、联合抗菌治疗、中性粒细胞缺乏是MM医院感染的易感因素;共检出74株真菌,白色假丝酵母菌占52.7%,光滑假丝酵母菌占20.3%,克柔假丝酵母菌占9.5%,热带假丝酵母菌占8.1%,近平滑假丝酵母菌占4.0%,烟曲霉菌占5.4%;氟康唑、伊曲康唑的敏感性降低,伏立康唑敏感性高。结论 MM患者医院真菌感染率增高,改善患者一般状况、减少侵入性操作、合理应用抗菌药物及对原发病的有效治疗,对预防医院真菌感染具有重要意义。
Objective To investigate the characteristics and risk factors of nosocomial fungal infection in patients with multiple myeloma (MM). Methods The clinical data of 219 patients with MM in our hospital from April 2000 to April 2010 were retrospectively analyzed. Results The incidence rate of fungal infection in 74 cases of secondary hospital was 58.5%, the infection rate was 26.5% and the infection rate was 33.8%. The respiratory tract was the main infection area, accounting for 91.9%. The fungal infection rate of hospital was gradually increased. The ECOG score, Sexual operation, combined antibacterial therapy and neutrophilic granulomatosis were the susceptible factors of MM hospital infection. A total of 74 fungi were detected, accounting for 52.7% of Candida albicans, 20.3% of Candida glabrata, Yeast accounted for 9.5%, Candida tropicalis accounted for 8.1%, Candida parapsilosis accounted for 4.0%, Aspergillus fumigatus accounted for 5.4%; fluconazole, itraconazole sensitivity decreased voriconazole sensitivity. Conclusion MM patients hospital fungal infection rate increased to improve the general condition of patients and reduce the invasive operation, rational use of antimicrobial agents and effective treatment of primary disease, to prevent hospital fungal infection is of great significance.