Pathogenic distribution and risk factors of invasive pulmonary fungal infection in patients with severe craniocerebral injury
Objective To investigate the etiological distribution and risk factors of invasive pulmonary fungal infection(IPFI)in patients with severe craniocerebral injury(SCCI),in order to provide scientific basis for improving the prognosis of SCCI.Methods A total of 160 patients with SCCI admitted to the Emergency Department of the First Affiliated Hospital of the PLA Air Force Medical University from September 1,2019 to August 31,2023 were divided into infected group(n=63)and uninfected group(n=97)according to whether they had concurrent IPFI.The distribution of fungi in the infected group was statistically analyzed,and the clinical data of the two groups were compared.The risk factors of concurrent IPFI in SCCI patients were analyzed by logistic regression,and the accuracy of predictive variables was evaluated according to receiver op-erating characteristics(ROC)curve.Results 63 pathogenic fungi were detected in the infection group,mainly Candida al-bicans(73.02％).Logistic multivariate analysis showed that age ≥65 years(OR=3.701),diabetes mellitus(OR=11.782),tracheotomy assisted ventilation time(OR=1.440),antibiotic application time(OR=2.221),and serum inter-leukin 17(IL-17)level(OR=1.647)were independent risk factors for IPFI in patients with SCCI vegetarian(P＜0.05).ROC analysis showed that the region under the curve(AUC)of joint prediction evaluation of IPFI was 0.951,95％CI was 0.916-0.987,sensitivity was 0.873,specificity was 0.948.Compared with the area under the curve of 0.5,the difference was statistically significant(P＜0.05).Conclusion The main pathogen of SCCI complicated with IPFI is Candida.Age ≥65 years old,diabetes mellitus,tracheotomy assisted ventilation time,antibiotic application time and serum IL-17 level are all independent risk factors for SCCI complicated with IPFI.
severe craniocerebral injurylung infectionfungal distributionrisk factor
万方数据
维普
