Harvey R L, Myers J P
Northeastern Ohio Universities College of Medicine, Rootstown.
Arch Intern Med. 1987 Dec;147(12):2117-20.
This report reviews 48 episodes of hospital-acquired fungemia that occurred over a four-year period at a large community teaching hospital. The incidence of hospital-acquired fungemia increased eightfold during the study period. Candida albicans (58%), Candida tropicalis (25%), and Candida parapsilosis (15%) were the most common fungal pathogens isolated from blood cultures. Twenty-one patients (44%) had concomitant bacteremia. Intravascular catheters (100%), antibiotic administration (98%), urinary catheters (81%), surgical procedures (65%), parenteral alimentation (60%), and corticosteroid administration (54%) were the most common predisposing factors. The overall mortality rate was 75%. Hospitalization on the medical service, age greater than 60 years, and hospital stay less than 100 days were associated with a significantly increased mortality rate.
本报告回顾了一家大型社区教学医院在四年期间发生的48例医院获得性真菌血症病例。在研究期间，医院获得性真菌血症的发病率增加了八倍。白色念珠菌（58%）、热带念珠菌（25%）和近平滑念珠菌（15%）是从血培养中分离出的最常见真菌病原体。21例患者（44%）合并有菌血症。血管内导管（100%）、抗生素使用（98%）、导尿管（81%）、外科手术（65%）、胃肠外营养（60%）和皮质类固醇使用（54%）是最常见的易感因素。总体死亡率为75%。在内科住院、年龄大于60岁以及住院时间少于100天与死亡率显著增加相关。
