The Investigation Of The Fungal Urinary Tract Infection And Risk Factor Analysis

ObjectiveTo explore and analyze the distribution, clinical characteristics and conditions of prognosis of fungal urinary tract infection of our hospital in recent three years and investigate the high risk factors which induce fungal urinary tract infection, provide certain help for clinical prevention and treatment.MethodsWe conducted a retrospective survey on 5,147 patients whose discharge diagnosis was urinary tract infection by all the clinical departments of the First Affiliated Hospital of Guangxi Medical University from January,2013 to December,2015. We brought 377 patients in whose urine culture was diagnosed as fungal urinary tract infection and learned its general condition and clinical characteristics. As for the risk factor analysis, according to the proportion of 1:1, we chose non-fungal urinary track infection patients of the same term and the same department and set them into the control group. For the potential factors, we first conducted single-factor analysis using chi-square test and introduced the meaningful variables (P<0.05) in the single-factor analysis into unconditional logistic regression analysis to conduct multiple-factor analysis.ResultsAmong the 5147 urinary tract infection patients, there are 377 fugal urinary tract infection; there are 195 male patients and 182 female patients; the detection rate is 7.3%. The detection time is mostly within 1 to 2 weeks after the admission; the rate is 42% and the fatality rate is 19.4%(including those discharged from hospital voluntarily). In three years, the detection rate of fungus increased from 6.9%,7.2% to 7.7%; the difference among the detection rate of four seasons has no statistic meaning. After urine bacterial culture or fungal culture and appraisal,388 fungi were extracted. Among these fungi, there are 168 C.albicans which account for 43.3%; secondly, there are 86 strains C.tropicalis which account for 22.8%; C.glabrata 70 strains which account for 18.0%. There are 49 patients who suffer from combined bacterial urinary tract infection. At the same time, there are 8 patients suffering from combined hemorrhagic fungal infection.The 377 patients mainly centered on comprehensive ICU, urinary surgery department, traditional Chinese medicine department, nephrology department, rehabilitation department and neurology department. The highest relevance ratio department is comprehensive ICU was 28.9%, followed by Communicable Diseases department, traditional Chinese medicine department, neurology department. As for the risk factor analysis, the single-factor chi-square test shows that 11 variables are the risk factors which influence fungal urinary track infection(P<0.05). We introduce these 11 variables into unconditional logistic regression analysis; according to OR, there is urinary track medical source invasive operation, combined with other severe basal disease, length of stay, antibiotic treatment course, combined long-term stay-in-bed disease,Urine tube indwelling time, antibiotic kinds and age.ConclusionThe detection rate of fungus in urinary infection of our hospital is increasing year by year. C.albicans, C.tropicalis and C.glabrata are the main pathogenic fungi which result in fungal urinary tract infection. As for patients with the above risk factors, they should pay attention to fungal infection and take precautionary measures against the above factors.