成人院內念珠菌血流感染流行病學特徵之分析

An Analysis of Nosocomial Candidemia among Hospitalized Adult Patients

吳淑萍(Shu-Ping Wu)；黃樹樺(Sue-Hwa Hwang)；黃高彬(Kao-Pin Hwang)；盧柏樑(Po-Liang Lu)；蔡季君(Jih-Jin Tsai)；李怡慧(Yi-Whey Lee)；林春珠(Shue-Ju Lin)；吳淑卉(Sue-Wehy Wu)

院內念珠菌血症 ； 危險因子 ； nosocomial candidemia ； risk factor

院內感染控制雜誌

12卷6期（2002 / 12 / 01）

355 - 365

繁體中文

A retrospective study was performed to investigate predisposing factors, clinical manifestations, and prognosis of adult patients with nosocomial candidemia at Kaohsiung Medical University Hospital, from January, 1998, till September, 2000. There was a total of 109 patients with the infection, with the prevalence of 1.32 per 1,000 discharges. The average age of patients was 61.9±15.9 years (median 64). There was no difference between the mcidences in the male and the female. The infection was 9.6 times more common in the intensive care units than in the regular wards (7.59% vs. 0.79%; p ＜0.001). Pre-infection hospital stay was 43.7±71.5 days (median 25), and the total hospital stay was 5-6 time longer than that of the average patients (82.1 ±128 days vs. 14±16 days; p＜0.01). The infected cases had underlying haemato-oncologic diseases (47.7%), gastrointestinal diseases (38.5%), or diabetes mellitus (34.7%). The 3 most common invasive procedures applied during the pre-infection admission periods were the insertion of indwelling central venous catheters (76.1%), Foley catheters (66.1%), and endotracheal tubes (52.3%). During the same period, 82.6% were given more than 3 kinds of antibiotics, and 45% given H2 blockers. The most common pathogen was Candida albicans (43%), followed by C. tropicalis (20%), C. parapsilosis (7.3 %), and C. intermedia (6.4%). Antifungal agents were given to 86 patients to treat the infection. The mortality rate was 40.4%. The significant risk factors (p＜0.05) included the old age (66.16±14.75 years), underlying haemato-oncologic diseases, cachexia, and septic shock.

A retrospective study was performed to investigate predisposing factors, clinical manifestations, and prognosis of adult patients with nosocomial candidemia at Kaohsiung Medical University Hospital, from January, 1998, till September, 2000. There was a total of 109 patients with the infection, with the prevalence of 1.32 per 1,000 discharges. The average age of patients was 61.9±15.9 years (median 64). There was no difference between the mcidences in the male and the female. The infection was 9.6 times more common in the intensive care units than in the regular wards (7.59% vs. 0.79%; p ＜0.001). Pre-infection hospital stay was 43.7±71.5 days (median 25), and the total hospital stay was 5-6 time longer than that of the average patients (82.1 ±128 days vs. 14±16 days; p＜0.01). The infected cases had underlying haemato-oncologic diseases (47.7%), gastrointestinal diseases (38.5%), or diabetes mellitus (34.7%). The 3 most common invasive procedures applied during the pre-infection admission periods were the insertion of indwelling central venous catheters (76.1%), Foley catheters (66.1%), and endotracheal tubes (52.3%). During the same period, 82.6% were given more than 3 kinds of antibiotics, and 45% given H2 blockers. The most common pathogen was Candida albicans (43%), followed by C. tropicalis (20%), C. parapsilosis (7.3 %), and C. intermedia (6.4%). Antifungal agents were given to 86 patients to treat the infection. The mortality rate was 40.4%. The significant risk factors (p＜0.05) included the old age (66.16±14.75 years), underlying haemato-oncologic diseases, cachexia, and septic shock.

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