Zhang G, Feng B B, Lu Z H, Su W, Wu Y S
Intensive Care Unit, Sir Run Run Shaw Hospital, Affiliated School of Medicine, Zhejiang University, Hangzhou 310016, China.
Zhonghua Yi Xue Za Zhi. 2017 Jul 25;97(28):2198-2201. doi: 10.3760/cma.j.issn.0376-2491.2017.28.008.
To explore the impact of antifungal therapy in mechanically ventilated patients with spp. colonization in lower respiratory tract. In this retrospective study, patients required mechanical ventilation with pulmonary spp. colonization admitted into the intensive care unit (ICU) between July 2012 and June 2016 were included. The patients were divided into the treatment group and control group according to whether or not they received antifungal therapy. The isolation rate of multidrug-resistant (MDR) bacteria, the incidence of ventilator-associated pneumonia (VAP), duration of mechanical ventilation, length of ICU stay, total length of hospital stay, the 28-day mortality and the overall mortality were compared between the two groups. Totally, 101 patients were studied. The number of cases in treatment group was 56 and the control group was 45. The treatment group had a lower incidence of MDR bacteria isolation rate and VAP compared with the control group (16.1% vs 33.3%, 5.4% vs 17.8% respectively, both <0.05). There were significant differences in the duration of mechanical ventilation [(17.3±5.7) days vs (22.5±7.2) days, <0.05], length of ICU stay [(23.3±5.6) days vs (28.7 ±4.8) days, <0.05] and the average length of hospital stay [(36.2±8.7) days vs (43.6±9.0) days, <0.05)] in the treatment group compared with the control group. There were no statistical difference between the two groups in the 28-day mortality and the overall mortality. Treatment of respiratory spp. colonization in mechanically ventilated patients may reduce isolation rate of MDR bacteria, the incidence of VAP, duration of mechanical ventilation, length of ICU stay and total length of hospital stay.
探讨抗真菌治疗对下呼吸道有某菌属定植的机械通气患者的影响。在这项回顾性研究中，纳入了2012年7月至2016年6月期间入住重症监护病房（ICU）且因肺部某菌属定植而需要机械通气的患者。根据是否接受抗真菌治疗将患者分为治疗组和对照组。比较两组患者多重耐药（MDR）菌的分离率、呼吸机相关性肺炎（VAP）的发生率、机械通气时间、ICU住院时间、总住院时间、28天死亡率和总体死亡率。共研究了101例患者。治疗组56例，对照组45例。治疗组MDR菌分离率和VAP的发生率低于对照组（分别为16.1%对33.3%，5.4%对17.8%，均<0.05）。治疗组与对照组相比，机械通气时间[（17.3±5.7）天对（22.5±7.2）天，<0.05]、ICU住院时间[（23.3±5.6）天对（28.7±4.8）天，<0.05]和平均住院时间[（36.2±8.7）天对（43.6±9.0）天，<0.05]存在显著差异。两组在28天死亡率和总体死亡率方面无统计学差异。对机械通气患者的呼吸道某菌属定植进行治疗可能会降低MDR菌的分离率、VAP的发生率、机械通气时间、ICU住院时间和总住院时间。
