Analysis Of Clinical Features And High-risk Factors Of 120 Cases Of Severe Acute Pancreatitis With Secondary Fungal Infection

Objective: To analyze the clinical characteristics and high-risk factors of fungal infections secondary to severe acute pancreatitis,and to provide lessons for clinical diagnosis and treatment.Methods: The clinical data of 120 cases of SAP from the First Affiliated Hospital of Chongqing Medical University from January 2013 to August 2020 were collected,and the receiver operating characteristic curve(ROC)was used to evaluate the APACHE Ⅱ score,fasting and drinking time,and broad spectrum at admission.The type of antibiotic used predicts the value of secondary fungal infections.Results: 48 suffered from secondary fungal infections of the 120 SAP patients,the incidence was 40.0%,74 sites of fungal infection,19 cases of respiratory tract infection(25.7%),of which 36 were treated with antifungal therapy,the improvement rate was 44.4%,and the mortality rate was 55.6%.Univariate analysis showed that secondary fungal infections were related to APACHE Ⅱ score at admission,time of fasting and drinking,ventilator use time,abdominal drainage tube,urinary tube,deep vein catheterization time,type and time of broad-spectrum antibiotic use,and length of hospital stay(P<0.05).Multivariate analysis showed that APAPCHE Ⅱ score at admission,long-term fasting and drinking,and the use of multiple antibiotics were independent risk factors for secondary fungal infection of SAP(P<0.05).The cut-off values of APACHEⅡ score,fasting and drinking time,and broad-spectrum antibiotic use were 17.5,3.5,and 11.5,respectively,which showed the best predictive performance.Conclusion: Respiratory tract is the most common site for SAP secondary fungal infection,Candida albicans infection is the most common,patients with APAPCHE Ⅱ score>17 at admission,fasting and drinking time>11 days,types of broad-spectrum antibiotics>3 types are prone to secondary fungal infections in the later period.