Analysis of incidence,drug resistance and risk factors of fungal infection in patients with digestive tract tumors after radiotherapy and chemotherapy
Objective To analyze the incidence,drug resistance and risk factors of fungal infection in patients with digestive tract tumor after radiotherapy and chemotherapy.Methods A total of 432 patients with gastrointestinal malignancies admit-ted to the First Affiliated Hospital of Air Force Medical University from May 2019 to December 2023 were selected to receive radiotherapy and chemotherapy treatment.The incidence of fungal infection after chemoradiotherapy was analyzed and fungal culture identification and drug sensitivity test were performed.Multivariate logistic regression analysis was used to identify the risk factors of fungal infection in patients with digestive tract tumors after radiotherapy and chemotherapy.Results The incidence of fungal infection was 19.67％ (85/432) in 432 patients with digestive tract malignant tumors.A total of 89 strains of pathoyenic fungi were identified by fungal culture,among which Candida albicans was the most common,ac-counting for 58.43％,followed by Candida tropicalis (17.98％) and Candida glabra (14.61％) and Candida krusei (5.75％).The drug resistance rates of Candida glabrata and Candida krusei to itraconazole were 53.85％ and 60.00％,respectively.The four Candida fungi were highly sensitive to voriconazole and amphotericin B.The proportion of patients in infection group ≥60 years old,≥2 cycles of chemoradiotherapy,indignant catheter/gastric tube,clinical stage Ⅲ～Ⅳ,hos-pital stay ≥30 d,invasive operation,antibiotic use ≥7 d was higher than that in non-infection group,the difference was sta-tistically significant (P<0.05).In the multivariate logistic regression model,the results showed that age ≥60 years,≥2 cycles of chemoradiotherapy,indurating catheter/gastric tube,duration of hospital stay ≥30 d and use of antibiotics ≥7 d were the risk factors for developing fungal infection after chemoradiotherapy (P<0.05).Conclusion Candida albicans is the main fungal infection in patients with digestive tract tumors after radiotherapy and chemotherapy.It is important to mo-nitor drug resistance to guide rational use of antibiotics,identify the risk factors of infection,and actively intervene to reduce the fungal infection rate.
万方数据
维普
