Clinical Analysis Of Invasive Fungal Infections In ICU

Objective:Investigate the current clinical features ,Genus characteristics, distribution and drug resistance of invasive fungal infections in comprehensive ICU, in order to the reference for clinical t reatment and degrade invasive fungal infections.Methods:Retrospective study the fungus-cultured positive cases among the patients in five years, according to the definite diagnosis of invasive fungal infections analyzed those cases, such as the patients age, potential disease, locations,species distribution and risk factors.Results:The rate of invasive fungal infection was 9.8% in comprehensive ICU. Isolating rate from sputum and urine accounting for 74. 1 % and 17. 2 %.The most common invasive fungal infection were Candida, accounting for 96.6%,among Candida albicans accounted for 58.6%. Fungi showed that drug sensitivity to amphotericin B and raconazole was higher , that to fluconazole and flucytosine was lower . The factors related to invasive fungal infection were severity and multiplicity of illness,invasive monitoring and therapeutic tool ,broad-spectrum antibiotic abuse , long term use of glucocorticoid , elderly patient with the severity of the potential disease, such as diabetes, chronic obstructive pulmonary disease(COPD) etc. Higher APACHⅡscores, more than 2 antibiotics, more than 2 weeks long-term use of hormone or/and immunosuppressant,intrusive monitoring and treatment method, chemotherapy or radiation therapy, coma≥2day, whole parenteral nutrition and neutropenia patients, all have statistically significant (P < 0.05), while malignant tumor, chronic organs insufficiency, gastrointestinal dysfunction,SOFA was statistically significant (P > 0.05).Conclusions:The rate of invasive fungal infections increased in recent 5 years in comprehensive ICU, Candida albicans are still the main pathogens. The infections incidence of non-C.albicans and the Aspergillus strains are increasing recent 5 years,there are significant difference in drug resistance of species, and has a raising tendency. so early diagnosis and experimental t reatment are very important. Old age, serious basic diseases, long-term use of hormone or/and immunosuppressant, intrusive monitoring and treatment means, long-term massively broad-spectrum antibiotics ,chemotherapy or radiation therapy, coma, total parenteral nutrition and neutropenia patients caused invasive fungal infection.