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目的:了解儿童念珠菌感染的临床危险因素并进行风险预测。方法:回顾性分析2001～2010年念珠菌培养阳性的本院儿科重症监护病房(PICU)患儿的临床资料。按1∶1比例选择年龄和性别相似、同期住院的念珠菌培养阴性PICU患儿作为对照。运用logistic回归分析相关危险因素并进行念珠菌感染的概率预测。结果:共有107例PICU患儿念珠菌培养阳性,年感染率具有上升的趋势。恶性肿瘤、中心静脉置管、糖肽类抗生素与抗厌氧菌抗生素使用超过3天均是独立的风险预测因素,其中中心静脉置管的校正后的OR值为25.68(95%CI:8.72～97.47)。当上述4个因素均存在时,PICU患儿念珠菌感染的概率为0.36(95%CI:0.01～0.97)。结论:应积极干预PICU患儿念珠菌感染的危险因素。
Objective: To understand the clinical risk factors of Candida infection in children and make risk prediction. Methods: The clinical data of patients with positive Candida culture in pediatric intensive care unit (PICU) from 2001 to 2010 were retrospectively analyzed. According to the ratio of 1: 1, the age and sex were similar, and the children with negative PICU during the same period of hospital stay were used as control. Logistic regression was used to analyze the risk factors and predict the probability of candida infection. Results: A total of 107 PICU children were positive for Candida culture, and the annual infection rate showed an upward trend. Malignancy, central venous catheterization, glycopeptide antibiotics and anti-anaerobic antibiotics were independent predictors of risk for more than 3 days, with a corrected OR of 25.68 (95% CI: 8.72 to 97.47) for central venous catheterization. When all of these four factors were present, the probability of candidiasis in PICU children was 0.36 (95% CI: 0.01-0.97). Conclusion: The risk factors of candida infection in PICU children should be positively intervened.