【摘要】 目的探讨呼吸科病房侵袭性真菌感染(IFI)的危险因素。方法对重庆市5家三甲医院呼吸内科诊断为真菌感染或呼吸道标本验出真菌的住院病例进行筛选,对选出的符合IFI诊断的病例采用多中心、回顾性、病例对照的研究方法,进行风险因素回顾性分析。对照组为同期呼吸科住院的非真菌的感染和定植病例。结果共筛选出IFI患者34例,对照组患者50例。IFI组与对照组的年龄、性别无显著差异(P>0.05)。IFI组住院天数、使用碳青霉烯类抗生素、化疗、深静脉置管、全胃肠外营养(TPN)、中性粒细胞减少和肾功能损害与对照组有显著差异。多因素Logistic回归分析显示使用碳青霉烯类抗生素(OR=6.753)、深静脉置管(OR=5.021)、TPN(OR=3.199)是呼吸科病人发生IFI的独立危险因素。结论碳青霉烯类抗生素、深静脉置管、TPN是呼吸科病人发生IFI的独立危险因素。更多还原

【Abstract】 Objective To explore the risk factors of invasive fungal infection (IFI) in respiratory ward. Methods A multi-center,retrospective,case-control study was carried out. Patients from five general hospitals in Chongqing city,diagnosed as fungal infection,or whose respiratory specimens were fungal positive,were retrospectively screened for IFI. Patients with respiratory infection and colonization of non-fungal cases in the same period of hospitalization were enrolled as control. Results Thirty-four patients diagnosed with IFI and 50 patients diagnosed with bacterial infection were analyzed for the risk factors of IFI. The demographic characteristics of patients including age and gender were not different(P>0.05),but hospitalization days,carbapenem antibiotic use,chemotherapy,deep venous catheterization,total parenteral nutrition(TPN),neutropenia,and renal disfunction were different significantly between the IFI group and the control group. Multiple logistic regression analysis showed that carbapenem antibiotic use (OR=6.753),central venous catheterization (OR=5.021) and TPN (OR=3.199) were main risk factors of invasive fungal infection. Conclusion The carbapenem antibiotic use,central venous catheterization and TPN are risk factors for IFI in respiratory ward.更多还原