重症监护病房患者真菌感染临床剖析.docVIP

重症监护病房患者真菌感染临床剖析 　　[摘要] 目的：对重症监护病房患者真菌感染情况进行临床分析。方法：对本院2009年2月～2010年2月重症监护病房发生真菌感染的33例患者，分别为血、尿、痰、局部引流物及中心穿刺针顶端真菌培养和药物敏感性试验阳性者。结果：本组33例真菌感染患者中，白色假丝酵母菌的感染率最高（36.4%），其次是热带假丝酵母菌（21.2%），感染部位以呼吸道为主，其次是泌尿道和穿刺针顶端。提示感染与侵入性操作和光谱抗生素的应用有关。克柔假丝酵母菌、光滑假丝酵母菌和热带假丝酵母菌对氟康唑的耐药性较高，分别为42.7%、37.5%、8.2%，所有菌株对二性霉素B和制霉菌素的敏感性均较好。结论：重症监护病房应合理使用抗生素，提高侵入性操作无菌化，从而降低真菌感染，提高治疗效果。 　　[关键词] 重症监护病房；真菌感染；分析 　　[中图分类号] R519 [文献标识码] C[文章编号] 1674-4721（2011）02（c）-066-02 　　 　　Clinical analysis of patients with fungal infections in ICU 　　HU Liyu, ZHOU Xusheng, TAN Zongchang 　　(The Second Hospital of Xiangtan City, Hunan Province, Xiangtan 411100, China) 　　[Abstract] Objective: To analyze fungal infection situation of Patients in the intensive care unit. Methods: 33 fungal infection patients in intensive care unit during February 2009 to February 2010 in our hospital were all positive in the test of blood, urine, sputum, local drain, fungal culture of the top of the needle and drug susceptibility. Results: In 33 patients of fungal infection, infection rate of candida albicans was highest(36.4%), followed by Candida tropicalis(21.2%), the site of infection was respiratory tract, followed by the urinary tract and puncture needle top. It told that infection was relevant with invasive procedures and the application of the spectrum antibiotics. Candida krusei, Candida and tropical smooth Candida resistance to fluconazole were higher, that were 42.7%, 37.5%, 8.2% separately. Sensitivity of all bacterial strain to amphotericin B and nystatin were good. Conclusion: The intensive care unit should be rational use of antibiotics to improve the sterile invasive procedures, thereby reducing the fungal infection, improve the therapeutic effect. 　　[Key words] Intensive care unit; Fungal infection; Analysis 　　 　　重症监护病房患者多病情危重，免疫力低下，在多种医源性侵入性操作和大量使用高效广谱抗生素的情况下，容易继发真菌感染，严重危及患者生命[1]。为了解本院重症监护病房真菌感染及耐药状况，笔者对33例患者的真菌感染情况进行了回顾性分析，现报道如下： 　　1 资料与方法 　　1.1 一般资料 　　选取本院2009年2月～2010年2月重症监护病房发生真菌感染患者33例为研究对象，分别为血、尿、痰、局部引流物及中