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[目的]了解医院不同病区住院患者呼吸道真菌感染的分布特征及相关因素。[方法]收集2007年1月以来院内7个科室(心内血液科、呼吸科、肿瘤科、肾内科、神内科、神外科、骨科)住院患者372人的深部痰标本,同时选择315例无基础疾病正常体检者的痰标本作为对照组,采用梅里埃公司微生物全自动分析仪及相关试剂条进行真菌鉴定。[结果]从住院患者中分离出真菌132株,真菌感染率10.5%(39/372),真菌携带率25.0%(93/372);其中心内血液科(40.5%)、呼吸科(24.6%)和肿瘤科(20.4%),住院患者真菌携带率最高。正常人群真菌携带率为5.4%(17/315)。接受抗生素、侵袭性操作及激素或免疫抑制剂治疗的患者其真菌感染率居首位,为50.0%,其次为接受抗生素、激素或免疫抑制剂治疗患者,真菌感染率为37.1%。[结论]广谱抗菌药物、激素和免疫抑制剂的使用、及侵袭性操作已成为医院内真菌感染的重要因素。同时老龄化、基础疾病尤其是呼吸道慢性疾病的患者是真菌定植和真菌感染的高危人群。
[Objective] To understand the distribution and related factors of respiratory tract fungal infection in hospitalized patients in different wards. [Method] A total of 372 in-hospital sputum specimens from 7 inpatients (cardiology, respiratory, oncology, nephrology, neurology, neurosurgery and orthopedics) were collected from January 2007 and 315 The sputum specimens of the normal subjects who suffered from basic diseases were used as the control group, and the fungi were identified by the automatic analyzer of microorganism and related reagents of Merial. [Results] 132 strains of fungi were isolated from hospitalized patients, the fungal infection rate was 10.5% (39/372) and fungal carrier rate was 25.0% (93/372) ) And oncology (20.4%). In-patients had the highest rate of fungal infection. Normal population fungal carrier rate was 5.4% (17/315). Infections with antibiotics, invasive procedures and hormones or immunosuppressive agents ranked the first with a prevalence of 50.0%, followed by antibiotics, hormones or immunosuppressive agents, with a fungal infection rate of 37.1%. [Conclusion] The use of broad-spectrum antimicrobial agents, hormones and immunosuppressive agents and invasive procedures have become important factors of fungal infections in hospitals. At the same time, aging, basic diseases, especially chronic respiratory diseases, are at risk of colonization and fungal infections.