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医院获得性念珠菌尿的危险因素。

Risk factors for nosocomial candiduria.

作者信息

Guler Selma, Ural Onur, Findik Duygu, Arslan Ugur

机构信息

Department of Infectious Diseases, Konya Meram Training and Research Hospital, Konyas, Turkey.

出版信息

Saudi Med J. 2006 Nov;27(11):1706-10.

Abstract

OBJECTIVE

To investigate the risk factors and the Candida species that cause candiduria in hospitalized patients via a case-control study.

METHODS

We evaluated the results of the urine analysis of the specimens sent to the laboratories of Central Microbiology and the Department of Clinical Bacteriology and Infectious Diseases of Selcuk University Medical School, Konya, Turkey between January and December 2004. The urinary specimens, sent from hospitalized patients, obtained within 72 hours were evaluated. A total of 51 patients above 17 years of age, without any bacterial growth in urine specimens, with fever above 38 degrees celcius and pyuria were included in this study. A control group of 153 patients without any bacterial growth at 72 hours after hospitalization was present. The average age of the patients, the hospitalization period, and clinics resemble each other in the 2 groups.

RESULTS

Risk for candiduria was increased by 4 folds (p=0.001; OR=4.020) in abdominal surgery, by 1.4 folds (p=0.335; OR:1.478) in corticosteroid and immune suppressive therapies and by 12 folds (p=0.000; OR=12.408) in urinary catheterization, antibiotic use increased the risk of candiduria by 6 folds (p=0.000; OR=6.00). The risk of candiduria was higher by 2 folds in diabetes mellitus patients than in the controls (p=0.044; OR=2.002).

CONCLUSION

Candida albicans (68.62%) was the most commonly isolated agent in candiduria patients. We should decrease the use of urinary catheters and avoid excess use of antibiotics as much as possible in hospitalized patients.

摘要

目的

通过病例对照研究调查住院患者发生念珠菌尿的危险因素及念珠菌种类。

方法

我们评估了2004年1月至12月间送至土耳其中部科尼亚市塞尔丘克大学医学院中央微生物学实验室以及临床细菌学与传染病科实验室的尿液分析结果。对住院患者在72小时内送检的尿液标本进行评估。本研究纳入了51例17岁以上、尿液标本无细菌生长、体温高于38摄氏度且有脓尿的患者。同时设有一个由153例住院72小时后无细菌生长的患者组成的对照组。两组患者的平均年龄、住院时间及科室情况相似。

结果

腹部手术患者发生念珠菌尿的风险增加4倍(p = 0.001;OR = 4.020),使用皮质类固醇和免疫抑制疗法的患者增加1.4倍(p = 0.335;OR = 1.478),导尿患者增加12倍(p = 0.000;OR = 12.408),使用抗生素使念珠菌尿风险增加6倍(p = 0.000;OR = 6.00)。糖尿病患者发生念珠菌尿的风险比对照组高2倍(p = 0.044;OR = 2.002)。

结论

白色念珠菌(68.62%)是念珠菌尿患者中最常分离出的病原体。在住院患者中,我们应减少导尿管的使用,并尽可能避免过度使用抗生素。

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