Fungal Infection:Analysis Of53Cases With Severe Acute Pancreatitis

Objective:Summary the routine data、 etiopathogenisis、clinical feature、 therapy, with the hope of improving the level of diagnosis and therapy of severe acute pancreatitis with fungal Infection.Methods:Review of the general data、etipathogenisis、 clinical feature、 auxiliary examination、 complications、 therapy and prognosis of53patients of severe acute pancreatitis with fungal Infection of Xiangya hospital from central-south university from Jan,2003to Aug,2012.Results:①routine data:In53patients,32cases(55.7%)were males and21cases(44.3%)were females; SAP with fungal infection frequently happened in people aged from30-59years old, the mean age was48.19±14.90.②Etiopathogenesis:the most common etiopathogenesis of SAP were biliary origin,hyperlipidemia and alcoh. The most common etiopathogenesis of SAP was biliary origin.③Length of stay in hospital:the average days of staying in hodpital were31.13±21.5.Aboult42patients staying in ICU,and the average days was17.96±17.05.④Clinical feature:the cold with no recognizable cause、 urgent or frequent urination、 abdominal distention and abdominal tenderness were the most common clinical manifestations.⑤Auxiliary examination: 44cases presented a positive finding who received the scan of B-ultrasound and52cases presented a positive finding who received the scan of CT, and the difference was significant.46cases of the SAP patients are infected mulripled.⑥acterial spectrum:what we got the most are fungal infection with G-cocuus29cases,54.71%, most are enterococcus.The sigle fungal infection15cases,28.3%, fungal infection with G+cocuus and G-cocuus9cases,17%.G-cocuus77cases,and verdigris Pseudomonca、Klebsiella pnenmoniae,20cases, pulmonary infection with50cases, peripancreas drainage. G+cocuus,16cases,represented4cases of urethra infection, infection of digestive canal, bacteremia and peripancreas drainage, Staphylococcus aureus,6cases. Enterococcus faecium,about6cases.⑦Therapy:about43cases have a high DUI which was high than DDD,mean overdose of antibiotics.The DUI≤1,9cases; DUI=1-1.99,29cases; DUI>2,14cases. Anti-fungal treatment group11cases,8deaths. Conventional treatment group19cases,5deaths, prevention treatment group of23patients,3patients died. Preventive treatment group mortality was significantly lower than the conventional treatment group, with significantly; APACHE II score from0to10,20patients,1patient died, the mortality rate of5%, the APACHE pi score11to20points,25cases,10died.the mortality was40%, APACHE II score21to30points and8patients,5patients died and the mortality rate was62.5%, P<0.05. Conclusion:1. SAP merger fungal infection is more common in middle-aged patients, the frequent caused by biliary, hyperlipidemia.2.SAP fungal infection mostly mixed with infections, fungal combined G-bacteria infection is more common.3.SAP merger fungal infections of patients with varying degrees of excessive use of broad-spectrum antibiotic.4. The prophylactic use of antifungal drugs could reduce the mortality of patients with fungal infections.