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目的研究重症监护病房(ICU)留置尿管患者尿路感染的真菌类型和定植状况,为临床预防治疗提供依据。方法采用回顾性调查方法,对2011年6月-2012年12月收住ICU的81例中段尿培养真菌阳性患者进行分析,并根据真菌菌落计数将其分为定植组和感染组,比较两组患者感染真菌类型及并发症发生率,采用SPSS13.0统计软件进行数据处理。结果 81株真菌中白色假丝酵母菌所占比例最高为58.02%,其次为热带假丝酵母菌、光滑假丝酵母菌,分别占29.62%、8.64%;感染组中以热带假丝酵母菌为主,占54.84%,而定植组中以白色假丝酵母菌为主,占72.00%;两组患者尿潜血阳性发生率均较高,分别为64.52%、62.00%;在并发尿路细菌及其他部位感染比较,差异均无统计学意义,但并发多部位感染发生率明显较高,感染组达90.32%、定植组达82.00%;感染组并发多药耐药菌感染率高于定植组,两组比较差异有统计学意义(P<0.05)。结论 ICU留置尿管患者尿路真菌类型与感染状态有关,真菌性尿路感染往往与细菌感染并存,在致病状态下并发多药耐药菌感染的概率更高,积极预防及治疗,有利于患者全身感染的控制。
Objective To study the fungal type and colonization status of urinary tract infection in intensive care unit (ICU) indwelling urethral catheterization and provide basis for clinical prevention and treatment. Methods A retrospective survey was conducted to analyze 81 cases of positive urine culture fungi in ICU from June 2011 to December 2012 and divided into colonization group and infection group according to fungal colonization count. Patients infected with fungal types and the incidence of complications, using SPSS13.0 statistical software for data processing. Results 81 strains of Candida albicans in the highest proportion of 58.02%, followed by Candida tropicalis, Candida glabrata, accounting for 29.62%, 8.64%; infection group with Candida tropicalis as Accounting for 54.84% of the total, while Candida albicans was the main component in the colonization group, accounting for 72.00%. The positive rates of urolithiasis in both groups were high (64.52% and 62.00%, respectively) There was no significant difference between the two groups. However, the incidence of complicated multi-site infection was significantly higher in the infected group (90.32%) and in the colonized group (82.00%). The infection rate of multidrug-resistant bacteria in the infected group was higher than that in the colonized group The difference was statistically significant (P <0.05). Conclusions The urinary tract fungal types in ICU patients with indwelling catheters are related to the status of infection. Fungal urinary tract infections often coexist with bacterial infections, and the probability of multidrug-resistant bacterial infections is higher in the pathogenic state, and the active prevention and treatment are beneficial Patients with systemic infection control.