本文選題：侵襲性念珠菌病 + 多中心研究　； 參考：《中國當(dāng)代兒科雜志》2017年04期

【摘要】：目的了解兒童侵襲性念珠菌病的臨床特征,探討念珠菌血流感染的危險(xiǎn)因素。方法選取2010年1月至2015年12月烏魯木齊市5家三級醫(yī)院確診或臨床診斷的134例侵襲性念珠菌病患兒為研究對象。采用多中心、回顧性研究方法,檢測患兒真菌感染類型及構(gòu)成比,比較念珠菌血流感染組及非血流感染組患兒的臨床資料,并應(yīng)用logistic多因素回歸分析探討念珠菌血流感染的危險(xiǎn)因素。結(jié)果 134例患兒中分離出134株念珠菌菌株,其中非白色念珠菌占53.0%。侵襲性念珠菌病在PICU及非PICU病區(qū)的發(fā)生率分別為41.8%、48.5%。血流感染為主(68例,50.7%),其次為尿路感染(45例,33.6%)。念珠菌血流感染組與非血流感組在年齡及廣譜抗生素使用率、慢性腎功能不全發(fā)生率、心力衰竭發(fā)生率、留置尿管率及非白色念珠菌感染率比較中差異有統(tǒng)計(jì)學(xué)意義(P0.05)。多因素logistic回歸分析顯示,年齡(1~24個(gè)月)(OR=6.027)、非白色念珠菌感染(OR=1.020)是念珠菌血流感染的獨(dú)立危險(xiǎn)因素。結(jié)論侵襲性念珠菌病在兒科ICU及非ICU病區(qū)發(fā)生率基本相同;感染菌株以非白色念珠菌為主;血流感染為最常見的念珠菌感染形式;年齡1~24個(gè)月及非白色念珠菌感染患兒發(fā)生念珠菌血流感染的風(fēng)險(xiǎn)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.
【作者單位】： 新疆醫(yī)科大學(xué)第一附屬醫(yī)院兒科;新疆醫(yī)科大學(xué)第一附屬醫(yī)院藥學(xué)部;新疆醫(yī)科大學(xué)第一附屬醫(yī)院新疆維吾爾自治區(qū)循證醫(yī)學(xué)研究所;
【分類號】：R725.1

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