Liu Yong, Sun Yongchang, Zhuo Jie, Liu Xiaofang
Department of Respiratory Medicine,Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
Department of Respiratory Medicine,Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China. Email:
Zhonghua Jie He He Hu Xi Za Zhi. 2014 Feb;37(2):99-103.
To investigate the clinical characteristics of and risk factors for candidemia combined with bacterial bloodstream infection(BSI) by retrospective analysis of cases.
The clinical data of cases diagnosed as candidemia combined with BSI confirmed by blood culture were compared with those of cases with mono-candidemia in Beiing Tongren Hospital from January 2009 to December 2011. A logistic regression analysis was performed to investigate the independent risk factors.
Forty-two cases diagnosed as candidemia were analyzed including 14 cases of candidemia combined with BSI and 28 cases of mono-candidemia. Ten strains of gram-positive cocci and 4 strains of gram-negative bacilli were isolated from candidemia combined with BSI group.Six strains of C.albicans, 4 strains of C.glabrata, 3 strains of C.tropicalis and 1 strain of C.krosei were isolated. There was no C.parapsilosis isolated from candidemia combined with BSI group but 9 strains in the mono-candidemia group. The septic shock rate of the candidemia combined with BSI group was higher than that of the mono-candidemia group (12/14 vs 7/28, P = 0.000). The mortality rate of the candidemia combined with BSI group was higher than that of the mono-candidemia group (10/14 vs 15/28), but the difference did not reach statistical significance (P = 0.266).Four factors were found statistically different by univariate analysis, including hospitalization more than 4 weeks (P = 0.001), bacteremia before candidemia(P = 0.005), hematological tumor (P = 0.01) and abdominal infection (P = 0.001). Multivariate analysis showed that hospitalization more than 4 weeks was the independent risk factor.
Gram-positive cocci were the predominant species and septic shock was more common in candidemia combined with BSI. Hospitalization more than 4 weeks was the independent risk factor for candidemia combined with BSI.
通过病例回顾性分析，探讨念珠菌血症合并细菌血流感染（BSI）的临床特征及危险因素。
将2009年1月至2011年12月在北京同仁医院确诊为念珠菌血症合并BSI的病例临床资料与单纯念珠菌血症病例进行比较。采用逻辑回归分析探讨独立危险因素。
共分析42例确诊为念珠菌血症的病例，其中念珠菌血症合并BSI 14例，单纯念珠菌血症28例。念珠菌血症合并BSI组分离出10株革兰阳性球菌和4株革兰阴性杆菌。分离出白色念珠菌6株、光滑念珠菌4株、热带念珠菌3株和克柔念珠菌1株。念珠菌血症合并BSI组未分离出近平滑念珠菌，而单纯念珠菌血症组有9株。念珠菌血症合并BSI组的感染性休克发生率高于单纯念珠菌血症组（12/14 vs 7/28，P = 0.000）。念珠菌血症合并BSI组的死亡率高于单纯念珠菌血症组（10/14 vs 15/28），但差异无统计学意义（P = 0.266）。单因素分析发现4个因素有统计学差异，包括住院时间超过4周（P = 0.001）、念珠菌血症前有菌血症（P = 0.005）、血液系统肿瘤（P = 0.01）和腹部感染（P = 0.001）。多因素分析显示住院时间超过4周是独立危险因素。
革兰阳性球菌是念珠菌血症合并BSI的主要菌种，感染性休克更常见。住院时间超过4周是念珠菌血症合并BSI的独立危险因素。
