Clinical characteristics of fungal infection in patients with infected pancreatic necrosis
Objective To analyze the clinical features of patients with infected pancreatic necrosis(IPN)complicated with fungal infection so as to identify possible risk factors for death.Methods We analyzed the clinical data of patients with IPN admitted to Xuanwu Hospital Capital Medical University from January 1,2017 to December 31,2021.According to the results of pancreatic necrotic tissue and drainage fluid culture,the patients were divided into the group with fungal infection and the group without fungal infection.The baseline data,clinical features and outcomes of the two groups were compared,and the risk factors for death in patients with fungal infection were analyzed.Results We included a total of 214 patients in the study,of whom 49 patients in the fungal infection group had wider necrotic involvement,lower hematopoietic volume,and higher blood glucose at admission.Patients with fungal infection had a higher proportion of multidrug-resistant bacteria(MDRB),and hospital and ICU stay as well as parenteral nutrition duration were also longer.In the group of patients with fungal infection,the proportion of patients undergoing surgery did not increase(P＞0.05),but the proportion of patients with perioperative organ failure and death was higher(P＜0.05).Candida albicans(44.8％)was the most common fungus detected,followed by Candida parapsilosis(28.6％)and Candida tropicalis(8.2％).Logistic regression analysis showed that MDRB infection(OR=1.37,95％CI:1.02-1.83),fungemia(OR=1.53,95％CI:1.06-2.23),hyperglycemia(OR=1.65,95％CI:1.28-2.10),new organ failure(OR=1.65,95％CI:1.19-2.29)and bleeding complications(OR=1.64,95％CI:1.28-2.10)after surgery were risk factors for death in patients with fungal infection.Conclusion Fungal infection increases mortality in patients with IPN and the incidence of new organ failure after surgery.Attention to fungemia,MDRB infection,hyperglycemia,organ failure and postoperative bleeding can help reduce the risk of death.
万方数据
维普
