Analysis Of Fungal Infections In General Hospitals In The Past Five Years

Objective:To review and analyze the clinical,treatment and prognosis of deep fungal infections and Candida glabrata infections in the First Affiliated Hospital of Kunming Medical University in the past five years;to clarify the status and characteristics of Candida glabrata infections in general hospitals,and to serve as references for the clinical diagnosis and treatment of Candida glabrata infections.Methods:A retrospective analysis was conducted on the hospitalized cases in the First Affiliated Hospital of Kunming Medical University from January 2015 to December 2019.The data including the general information of patients who with deep fungal infections and Candida glabrata infections,primary disease-related information,fungal infections,and use of antifungal drugs were collected for statistical analysis.SPSS 25.0 was applied to analyze the epidemiological characteristics,treatment and prognosis of deep fungal infections and Candida glabrata infections.Results:1.Retrospective analysis of 528,743 cases,the incidence of deep fungal infections in the First Affiliated Hospital of Kunming Medical University showed an overall upward trend from 2015 to 2019;the incidence of Candida glabrata also showed an upward trend in the past five years,with slight fluctuations,and the incidence in 2018 The highest rate(0.015%).2.Patients with deep fungal infections and Candida glabrata infections are more male than female,and the proportion of males is close to 70%;it mainly occurs in patients over 60 years old(57.66%,50.00%).3.Deep fungal infections and Candida glabrata infections mainly occurred in the respiratory department(34.31%,37.50%),followed by transplantation(12.41%,21.43%)and cardiology(10.95%,8.93%).The infections sites were mainly in the respiratory tract(93.07%,98.21%).4.Candida infections still accounts for the first place in deep fungal infections,among which Candida albicans is still the main pathogen of deep fungal infections(60.53%),followed by Candida glabrata(21.05%).5.The main susceptibility factors for deep fungal infections and Candida glabrata infections are antibiotics(97.45%,98.21%),indwelling catheters(42.34%,50.00%),and glucocorticoids(41.24%,46.43%).6.Infectious diseases are common underlying disease of deep fungal infections(59.49%)and Candida glabrata infections(55.36%).7.The treatment of deep fungal infections and Candida glabrata infections in the First Affiliated Hospital of Kunming Medical University mostly uses fluconazole(38.32%,33.93%)and voriconazole(35.40%,48.21%).Most antifungal treatments are based on single medication(75.74%,78.00%).8.Most patients with deep fungal infections have a good prognosis(55.84%).Those with underlying diseases have a worse prognosis than those without underlying diseases.Among them,those with renal insufficiency and neurological diseases have a worse prognosis.9.For Candida glabrata infections,the prognosis of those who use Echinocandins antifungal drugs is better than those who use other antifungal drugs such as azoles.Conclusions:1.From 2015 to 2019,the deep fungal infections rate and Candida glabrata infections in the First Affiliated Hospital of Kunming Medical University both showed an upward trend.2.The Candida albicans infection rate gradually declined;deep fungal infections and Candida glabrata infections mostly occur in patients over 60 years old,with more men than women.3.The high-incidence departments of deep fungal infections are the respiratory department and transplantation department,and the most common sites are the respiratory system and central nervous system.The Candida glabrata infections specimens are mainly derived from sputum,followed by alveolar fluid and bronchial secretions.4.Patients with deep fungal infections with renal insufficiency and neurological diseases have a worse prognosis than those without these two underlying diseases.5.For Candida glabrata infections,it is recommended to choose echinocandin antifungal drugs first,and the patient’s prognosis is better.