摘要
目的探讨急性脑梗死患者下呼吸道真菌感染、定植真菌的分布特点,旨在为预防措施提供参考依据。方法采用回顾性调查的方法对2010年1月-2013年1月收治的208例急性脑梗死患者临床资料进行分析,对出现下呼吸道真菌定植的患者进行病原学分析,同时对急性脑梗死合并下呼吸道真菌定植的危险因素进行logistic回归分析,确定脑梗死患者下呼吸道真菌感染的影响因素,并提出针对性的预后措施。结果 208例急性脑梗死患者的下呼吸道标本中,检出真菌感染95份,感染率为45.67%,其中以白色假丝酵母菌感染率最高为37.91%,其次为曲霉菌属感染占16.99%;真菌定植分析显示,假丝酵母菌属定植的病例数最多;多因素logistic回归分析显示,急性脑梗死患者下呼吸道真菌定植的常见危险因素为老年患者、意识障碍、长期应用抗菌药物等;出现下呼吸道真菌定植的急性脑梗死患者与未出现真菌定植的急性脑梗死患者在住院时间、病情加重及病死率方面比较,差异均有统计学意义(P<0.01)。结论急性脑梗死患者下呼吸道真菌定植发生率较高,假丝酵母菌属是主要的病原菌,积极控制真菌感染的危险因素是降低急性脑梗死患者下呼吸道真菌定植和提高患者生存的关键,早诊断、早治疗、采取针对性的干预措施是预防急性脑梗死患者下呼吸道真菌定植和改善预后的重要手段。
OBJECTIVE To explore the distribution of fungi causing lower respiratory tract infections or colonized fungi in the patients with acute cerebral infarction so as to put forward the prevention measures.METHODS A retrospective survey was conducted for the clinical data of 208 patients with acute cerebral infarction who were treated in the hospital from Jan 2010 to Jan 2013.The etiological examination was carried out for the patients with lower respiratory tract fungal colonization,the logistic regression analysis was performed for the risk factors for the complicated lower respiratory tract fungal colonization in the patients with acute cerebral infarction so as to determine the influencing factors for the lower respiratory tract fungal infections,and the targeted prognosis measures were put forward.RESULTS A total of 95 lower respiratory tract specimens with fungal infections were detected from the 208 patients with acute cerebral infarction,with the infection rate of 45.67%.The incidence of Candida albicans infections was the highest（37.91%）,followed by the incidence of Aspergillus infection（16.99%）.The analysis of the fungal colonization indicated that the Candida colonization cases were dominant.The multivariate logistic regression analysis showed that the common risk factors for lower respiratory tract fungal colonization in the patients with acute cerebral infarction included the advanced age,disturbance of consciousness,and long-term use of antibiotics.There was significant difference in the length of hospital stay,exacerbation of illness,or mortality rate between the acute cerebral infarction patients with lower respiratory tract fungal colonization and those without lower respiratory tract fungal colonization（P〈0.01）.CONCLUSIONThe incidence of the lower respiratory tract fungal colonization is high in the patients with cerebral infarction.Candidais dominant among the pathogens.It is crucial to actively control the risk factors for fungal infections so as to reduce the incidence of the lower r
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第17期3887-3889,共3页
Chinese Journal of Nosocomiology
基金
山东省卫生厅基金资助项目(SW-2012B036)
关键词
急性脑梗死
下呼吸道
真菌
定植
预后
Acute cerebral infarction
Lower respiratory tract
Fungi
Colonization
Prognosis
