Ventilator associated pulmonary candida infection in intensive care units in the Meizhou region of China: species distribution and resistance, the risk factors for patient mortality and resistance, the risk factors for patient mortality
XIAO Guang-wen 1, ZHANG Guo-xiong 2, LUO Xiao-dong 1,YANG Ying-ping 1, CAI Guo-xiong 1
Abstract:Ventilator associated pulmonary candida infectionsis (VAPCI) is one of the important factors in the death of ICU patients, but available datas are limited. Our objective was to characterize the fungal pathogens that cause ventilator?associated pneumonias(VAP) and determine the epidemiology and risk factors for patient mortality among ICU patients in Meizhou, China. Of 319 ICU patients with VAPCI during their stays were included in the study conducted in Meizhou region from January 2010 to December 2017. Blood cultures were performed and the antimicrobial susceptibility profiles of the resulting isolates were determined. Logistic multiple regression and receiver operating characteristics (ROC) curve analysis were used to assess the risk factors for mortality among the cases. Results showed that the prevalence of VAPCI in ICU patients was 2.19% (319/14,597) with a mortality rate of 53.29% (171/319). The 343 strains of VAP Candida spp. were identified from these patients. Candida albicans was most common (46.36%), others were Candida tropicalis, Candida glabrata, Candida parapsilosis, Candida krusei, and Candida albicans. C. glabrata was less than 80% sensitive to azole drugs. Logistic multiple regression showed that age,malignant tumor,serum albumin, acute physiology and chronic health evaluation (APACHE) II score, three or more underlying diseases, catheter retention time,and length of stay in ICU were independent risk factors for mortality in VAPCI. ROC curve analysis showed that APACHE II scores >19 and serum albumin ≤25 g/L were the best predictors of mortality. In conclusio, C. albicans predominated in the patients of VAPCI in ICU, with high mortality. Thus, the clinical doctors should attach importance to the above risk factors of patients with enhanced monitoring and fungal susceptibility monitoring to reduce the mortality of patients.
肖光文,张国雄,罗晓东,杨迎平,蔡国雄. ICU患者呼吸机相关肺部念珠菌感染的物种分布、药敏及患者死亡危险因素的分析[J]. 中国人兽共患病学报, 2019, 35(7): 613-619.
XIAO Guang-wen, ZHANG Guo-xiong, LUO Xiao-dong,YANG Ying-ping, CAI Guo-xiong. Ventilator associated pulmonary candida infection in intensive care units in the Meizhou region of China: species distribution and resistance, the risk factors for patient mortality and resistance, the risk factors for patient mortality. Chinese Journal of Zoonoses, 2019, 35(7): 613-619.
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