ICU呼吸机相关性肺部假丝酵母菌属感染的危险因素及耐药性检测
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摘要
目的分析ICU呼吸机相关性肺部假丝酵母菌属感染的危险因素,并对其耐药性进行检测,以提供治疗有效数据。方法选取2009年2月-2011年11月在医院ICU行呼吸机机械通气治疗的患者122例,根据是否出现肺部假丝酵母菌属感染,将患者分为试验组(肺部出现假丝酵母菌属感染组)55例及对照组(肺部未出现假丝酵母菌属感染组)67例,比较两组患者一般临床资料,并对假丝酵母属进行药敏试验。结果试验组患者中>65岁占65.5%、吸烟占60.0%、合并≥2种基础疾病占49.1%、合并糖尿病占34.5%、住院>2周占40.0%,均明显高于对照组;试验组患者抗菌药物使用>1周的患者为76.4%、频繁更换为52.7%、预防性使用抗真菌药物为47.3%、使用广谱抗菌药物为63.6%、联合使用为65.5%,与对照组比较差异有统计学意义。结论抗菌药物使用不够规范均是ICU呼吸机相关性肺部假丝酵母菌属感染的相关因素,分析假丝酵母菌属的耐药性对患者的诊疗用药起到一定作用。
OBJECTIVE To analyze the risk factors of ventilator-associated pulmonary Candida infections in ICU and detect its drug resistance so as to provide the reliable data.METHODS From Feb,2009 to Nov 2011,122 patients who underwent the mechanical ventilation were divided into two groups according to whether they had pulmonary Candida infections: the experimental group(with pulmonary Candida infection group,n=55) and the control group(without pulmonary Candida infection group,n=67).The clinical data of the two groups of patients were compared,and the drug susceptibility testing of the Candida was performed.RESULTS In the experimental group,65.5% of the patients were more than 65 years old,60.0% with smoking history,49.1% with more than two basic complications,34.5% with diabetes mellitus complication,and 40% with the hospitalization duration more than 2 weeks,all of which were significantly higher than that of the control group;in the experimental group,76.4% of patients used antibiotics for more than one week,52.7% with the frequent change,47.3% with the use of prophylactic antifungal drugs,63.6% with the use of broad spectrum antibiotics,65.5% with combination use of antibiotics,as compared with the control group,the difference was statistically significant.CONCLUSION The unreasonable use of antibiotics is a related factor for the ventilator-associated pulmonary Candida infections in the ICU.To analyze the drug resistance of Candida will be helpful to the use of antibiotics.
OBJECTIVE To analyze the risk factors of ventilator-associated pulmonary Candida infections in ICU and detect its drug resistance so as to provide the reliable data.METHODS From Feb,2009 to Nov 2011,122 patients who underwent the mechanical ventilation were divided into two groups according to whether they had pulmonary Candida infections: the experimental group(with pulmonary Candida infection group,n=55) and the control group(without pulmonary Candida infection group,n=67).The clinical data of the two groups of patients were compared,and the drug susceptibility testing of the Candida was performed.RESULTS In the experimental group,65.5% of the patients were more than 65 years old,60.0% with smoking history,49.1% with more than two basic complications,34.5% with diabetes mellitus complication,and 40% with the hospitalization duration more than 2 weeks,all of which were significantly higher than that of the control group;in the experimental group,76.4% of patients used antibiotics for more than one week,52.7% with the frequent change,47.3% with the use of prophylactic antifungal drugs,63.6% with the use of broad spectrum antibiotics,65.5% with combination use of antibiotics,as compared with the control group,the difference was statistically significant.CONCLUSION The unreasonable use of antibiotics is a related factor for the ventilator-associated pulmonary Candida infections in the ICU.To analyze the drug resistance of Candida will be helpful to the use of antibiotics.
引文
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