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背景 : 近年来 ,随着广谱抗生素的应用及危重病人的增多 ,深部真菌日益成为医院内感染的主要病原菌之一。在深部真菌感染中念珠菌感染又占其中的大部分。为了更好的预防和治疗院内深部念珠菌感染 ,我们对本院该菌的感染进行了菌种类型调查和危险因素分析。目的 : 研究本院深部念珠菌感染的危险因素及菌种类型分布。方法 : 对北京医科大学第一医院从 1998年 6月至 1999年 12月住院和急诊留观病人不同部位念珠菌培养阳性的临床标本进行致病菌种调查。同时从中选取了 15 0例病人进行危险因素的评价。结果 : (1)在我院 1年半的时间内共有 5 95份念珠菌培养阳性的临床标本 ,其中白念珠菌为主要的病原菌 ,占 72 .6 %。以后依次为热带念珠菌、光滑念珠菌和近平滑念珠菌 ;(2 )在深部念珠菌感染中 ,89.3%的患者长期应用广谱抗生素 ,2 0 %以上的患者存在应用激素治疗 ,合并恶性肿瘤 ,外科手术以及合并糖尿病的危险因素 ;(3)在血培养阳性 8例病人中 ,4例应用了中央静脉插管 ;(4 ) 30例尿培养阳性的患者 ,86 .6 %长期应用广谱抗生素 ,5 6 .7%应用尿管。结论 : (1)我院的院内深部念珠菌感染 ,白念珠菌为首要致病菌 ;(2 )长期应用广谱抗生素是院内深部念珠菌感染最常见的危险因素。应用激素治疗 ,合并恶性肿瘤
BACKGROUND: In recent years, with the application of broad-spectrum antibiotics and the increase of critically ill patients, deep fungi are increasingly becoming one of the major pathogens in nosocomial infections. Candida infection in deep fungal infections account for most of them. In order to better prevent and treat deep Candida infections in the hospital, we investigated the type of bacteria in this hospital and analyzed the risk factors. Objective: To study the risk factors of Candida albicans infection in our hospital and the distribution of strain types. Methods: Pathogens were investigated in clinical specimens of Candida positive in different parts of hospitalized and emergency patients in Beijing First Medical University from June 1998 to December 1999. At the same time, 150 patients were selected for risk factor evaluation. Results: (1) A total of 955 Candida albicans positive clinical specimens were obtained in our hospital over a year and a half, of which Candida albicans was the main pathogen, accounting for 72.6%. Followed by Candida tropicalis, Candida glabrata and Candida parapsilosis; (2) In deep Candida infections, 89.3% of patients long-term use of broad-spectrum antibiotics, 20% of patients with hormone therapy exist, the merger of malignant tumors , Surgery and risk factors associated with diabetes mellitus; (3) 4 of 8 patients with positive blood culture had central venous catheterization; (4) 30 of the 30 urine-positive patients had long-term use of broad spectrum Antibiotics, 56.7% of the application of catheter. Conclusions: (1) Candida albicans infection and Candida albicans are the most important pathogens in our hospital. (2) Long-term use of broad-spectrum antibiotics is the most common risk factor of Candida infection in the hospital. Hormone therapy, with malignant tumors