乌鲁木齐市多中心儿童侵袭性念珠菌病临床特征及其血流感染的危险因素分析

发布时间：2018-07-04 20:40

本文选题：侵袭性念珠菌病 + 多中心研究　；参考：《中国当代儿科杂志》2017年04期

【摘要】：目的了解儿童侵袭性念珠菌病的临床特征,探讨念珠菌血流感染的危险因素。方法选取2010年1月至2015年12月乌鲁木齐市5家三级医院确诊或临床诊断的134例侵袭性念珠菌病患儿为研究对象。采用多中心、回顾性研究方法,检测患儿真菌感染类型及构成比,比较念珠菌血流感染组及非血流感染组患儿的临床资料,并应用logistic多因素回归分析探讨念珠菌血流感染的危险因素。结果 134例患儿中分离出134株念珠菌菌株,其中非白色念珠菌占53.0%。侵袭性念珠菌病在PICU及非PICU病区的发生率分别为41.8%、48.5%。血流感染为主(68例,50.7%),其次为尿路感染(45例,33.6%)。念珠菌血流感染组与非血流感组在年龄及广谱抗生素使用率、慢性肾功能不全发生率、心力衰竭发生率、留置尿管率及非白色念珠菌感染率比较中差异有统计学意义(P0.05)。多因素logistic回归分析显示,年龄(1~24个月)(OR=6.027)、非白色念珠菌感染(OR=1.020)是念珠菌血流感染的独立危险因素。结论侵袭性念珠菌病在儿科ICU及非ICU病区发生率基本相同;感染菌株以非白色念珠菌为主;血流感染为最常见的念珠菌感染形式;年龄1~24个月及非白色念珠菌感染患儿发生念珠菌血流感染的风险增加。
[Abstract]:Objective to investigate the clinical features of invasive candidiasis in children and to explore the risk factors of candidiasis. Methods 134 children with invasive candidiasis were selected from January 2010 to December 2015 in 5 tertiary hospitals in Urumqi. The types and composition of fungal infection in children were determined by a multicenter retrospective study. The clinical data of patients with candida blood flow infection and those with non-blood infection were compared. Logistic multivariate regression analysis was used to study the risk factors of Candida blood flow infection. Results 134 strains of Candida were isolated from 134 children, among them, non-albicans accounted for 53.0%. The incidence of invasive candidiasis in PICU and non-PICU was 41.8% and 48.5% respectively. Blood flow infection was predominant (68 cases, 50.7%), followed by urinary tract infection (45 cases, 33.6%). There were significant differences in age and broad-spectrum antibiotic utilization rate, chronic renal insufficiency rate, heart failure rate, indwelling urinary catheter rate and non-white Candida infection rate between the two groups (P0.05). Multivariate logistic regression analysis showed that age (1- 24 months) (OR6.027) and non-Candida albicans infection (OR1.020) were independent risk factors for candida blood flow infection. Conclusion the incidence of invasive candidiasis in pediatric ICU and non-ICU is basically the same. Age 1-24 months and children with non-Candida albicans infection increased the risk of Candida hemolyticus infection.
【作者单位】：新疆医科大学第一附属医院儿科;新疆医科大学第一附属医院药学部;新疆医科大学第一附属医院新疆维吾尔自治区循证医学研究所;
【分类号】：R725.1

【相似文献】