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[重症监护病房的念珠菌尿症:尿液中酵母菌计数的意义和价值]

[Candiduria in intensive care unit: significance and value of yeast numeration in urine].

作者信息

Sellami A, Sellami H, Makni F, Bahloul M, Cheikh-Rouhou F, Bouaziz M, Ayadi A

机构信息

Laboratoire de Parasitologie-Mycologie, Faculté de Médecine, Sfax, Tunisie.

出版信息

Ann Fr Anesth Reanim. 2006 Jun;25(6):584-8. doi: 10.1016/j.annfar.2006.02.019. Epub 2006 Apr 19.

Abstract

JUSTIFICATION

Candiduria is increasingly frequent among patients admitted to intensive care units but its significance remains unclear.

OBJECTIVES

Search for eventual correlation between quantitative candiduria and known risk factors for invasive candidiasis.

STUDY DESIGN

Prospective.

PATIENTS AND METHODS

A four-month study was conducted in 162 patients hospitalized in the intensive care unit for more than 72 hours. All patients underwent a weekly research of candiduria added to sampling from different body sites to determine the Pittet Candida colonization index.

RESULTS

Candiduria has been proved in 56 cases (34%). It was superior or equal to 10(4) UFC/ml among 28 patients (50%). Candida tropicalis, Candida glabrata and Candida albicans has been isolated in 41, 22 and 20% respectively. All patients had at least one major and two minor risk factors for Candida infection. Six patients (10%) developed invasive candidiasis. The global mortality rate was at 52%. Pittet colonization index was significantly different between patients with candiduria and those with invasive candidiasis (p=0.01). There was a statistically significant correlation between candiduria superior or equal to 10(4) UFC/ml and Pittet colonization index superior or equal to 0.5 (p=0.01).

CONCLUSION

Candiduria superior or equal to 10(4) UFC/ml associated with risk factors may predict invasive candidiasis in critically ill patients.

摘要

理由

念珠菌尿在重症监护病房患者中越来越常见,但其意义仍不明确。

目的

寻找念珠菌尿定量与侵袭性念珠菌病已知危险因素之间的潜在相关性。

研究设计

前瞻性研究。

患者与方法

对162名在重症监护病房住院超过72小时的患者进行了为期四个月的研究。所有患者每周进行念珠菌尿检测,并从不同身体部位取样以确定皮特念珠菌定植指数。

结果

56例(34%)患者证实有念珠菌尿。28例(50%)患者念珠菌尿菌量≥10⁴CFU/ml。热带念珠菌、光滑念珠菌和白色念珠菌的分离率分别为41%、22%和20%。所有患者至少有一项主要和两项次要念珠菌感染危险因素。6例(10%)患者发生侵袭性念珠菌病。总死亡率为52%。念珠菌尿患者与侵袭性念珠菌病患者的皮特定植指数有显著差异(p=0.01)。念珠菌尿菌量≥10⁴CFU/ml与皮特定植指数≥0.5之间存在统计学显著相关性(p=0.01)。

结论

念珠菌尿菌量≥10⁴CFU/ml并伴有危险因素可能预示重症患者发生侵袭性念珠菌病。

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