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目的调查分析ICU重症肺炎合并真菌感染患者的感染情况。方法收集2013年1月至2014年12月80例ICU重症肺炎患者,随机选取40例诊断为ICU重症肺炎合并真菌感染患者,对其下呼吸道或痰液进行采样,并对其中的真菌进行培养及分析,通过其真菌的数量及种类,对ICU重症肺炎合并真菌感染患者的感染情况与影响因素进行讨论以及分析。结果 40例患者真菌培养结果共发现5种真菌,其中白假丝酵母菌7株(17.5%),热带假丝酵母菌6株(15.0%),接合酵母菌5株(12.5%),可柔假丝酵母菌3株(7.5%),阿萨酵母菌19株(47.5%)。患者因长期使用免疫抑制剂而感染者12例,感染率为30.0%;因长期使用糖皮质激素而感染者11例,感染率为27.5%;因大量使用广谱抗菌药物而感染者25例,感染率为62.5%。结论 ICU重症肺炎合并真菌感染患者感染率高与其免疫功能低下、营养状况差以及基础疾病多有关。同时长期使用免疫抑制剂、长期使用糖皮质激素、气管切开和气管插管、白细胞降低、低蛋白血症、进入ICU≥1周以及大量使用广谱抗菌药物是引起ICU重症肺炎合并真菌感染发生情况的主要影响因素。
Objective To investigate and analyze the infection of ICU patients with severe pneumonia and fungal infection. Methods From January 2013 to December 2014, 80 patients with severe pneumonia in ICU were enrolled. 40 patients diagnosed as ICU severe pneumonia complicated with fungal infection were randomly selected, their lower respiratory tract or sputum were sampled and their fungi were cultured and Analysis and through the number and types of fungi, ICU severe pneumonia complicated with fungal infection in patients with infection and the impact of factors were discussed and analyzed. Results Four fungal cultures were found in 40 patients, including 7 Candida albicans (17.5%), 6 Candida tropicalis (15.0%) and 5 (12.5%) Saccharomyces cerevisiae Candida 3 (7.5%), Assam yeast 19 (47.5%). Twelve patients were infected with long-term use of immunosuppressive agents, the infection rate was 30.0%. Eleven patients were infected with glucocorticoid for a long time, the infection rate was 27.5%. Infection caused by extensive use of broad-spectrum antimicrobial agents was found in 25 patients, The infection rate was 62.5%. Conclusion ICU patients with severe pneumonia complicated with fungal infection infection rate is high and its immune dysfunction, poor nutritional status and more underlying diseases. Long-term use of immunosuppressive agents, long-term use of glucocorticoids, tracheostomy and tracheal intubation, leukopenia, hypoproteinemia, into the ICU ≥ 1 week and extensive use of broad-spectrum antibiotics is caused by ICU severe pneumonia complicated with fungal infection The main factors affecting the situation.