假丝酵母复杂性泌尿道感染不良预后危险因素
Risk factors for poor prognosis of patients with complicated urinary tract infection due to Candida
张艳 1朱志刚 1杜文颖 1吴晓妹 1王玉宝2
作者信息
- 1. 天津医科大学第二医院感染性疾病科,天津 300211
- 2. 天津医科大学总医院呼吸科,天津 300052
- 折叠
摘要
目的 分析假丝酵母引起的复杂性泌尿道感染(cUTI)住院患者临床不良预后(住院时间延长)的危险因素.方法 收集天津医科大学第二医院2020年7月1日-2022年6月30日收治的成人假丝酵母cUTI住院患者临床及病原学资料,以患者住院时间延长作为评估预后的指标,其中49例患者住院时间≥15 d为预后不良组,33例患者住院时间＜15 d为预后良好组,采用多因素Logistic回归分析患者不良预后的危险因素.结果 82例假丝酵母cUTI患者尿培养共分离到82株假丝酵母菌株,其中白假丝酵母有47株占57.3％,非白假丝酵母有35株占42.7％,有24株占29.3％对氟康唑、伊曲康唑等唑类抗真菌药物耐药;预后不良组中医院获得性感染、脑梗死和卧床患者占比高于预后良好组(P＜0.05),两组年龄矫正查尔森合并症指数(ACCI)、留置导尿管、经泌尿道手术、白假丝酵母、对唑类耐药患者占比比较无统计学差异;多因素分析发现医院获得性cUTI是患者预后不良的危险因素(OR=3.530,95％CI:1.260～9.870).结论 假丝酵母引起的cUTI检出的真菌主要为白假丝酵母,医院获得性感染是假丝酵母cUTI住院患者住院时间延长的独立危险因素.
Abstract
OBJECTIVE To analyze the risk factors for poor clinical prognosis(extension of length of hospital stay)of the patients with complicated urinary tract infection(cUTI)due to Candida.METHODS The clinical and etio-logical data were collected from the adult patients with Candida cUTI who were hospitalized for treatment in the Second Hospital of Tianjin Medical University from Jul 1,2020 to Jun 30,2022.The extension of length of hos-pital stay was taken as the index for assessment of prognosis.49 patients whose length of hospital stay was no less than 15 days were assigned as the poor prognosis group,and 33 patients whose length of hospital stay was less than 15 days were assigned as the favorable prognosis group.Multivariate logistic regression analysis was per-formed for the risk factors for the poor prognosis of the patients.RESULTS Totally 82 strains of Candida were i-solated from urine culture for the 82 patients with Candida cUTI,47(57.3％)of which were Candida albicans,and 35(42.7％)were non-C.albicans strains.Totally 24(29.3％)strains were resistant to fluconazole and itra-conazole.The proportions of patients who had hospital-acquired infection,cerebral infarction and the proportion of bedridden patients were higher in the poor prognosis group than in the favorable prognosis group(P＜0.05).There were no significant differences in the age-adjusted Charlson comorbidity index(ACCI)and the proportions of patients with urinary catheter indwelling.The multivariate analysis showed that the hospital-acquired cUTI was the risk factor for the poor prognosis of the patients(OR=3.530,95％CI:1.260-9.870).CONCLUSION C.albi-cans is the predominant species of fungi that cause the cUTI.The hospital-acquired infection is the independent risk factor for the extension of length of hospital stay of the hospitalized patients with Candida cUTI.
关键词
假丝酵母/复杂性泌尿道感染/预后/危险因素/医院感染Key words
Candida/Complicated urinary tract infection/Prognosis/Risk factor/Nosocomial infection引用本文复制引用
基金项目
天津市卫生健康委员会高层次人才培养资助项目(TJSJMYXYC-D2-024)
出版年
2024
NETL
NSTL
维普
万方数据