| ObjectiveTo investigate the distribution characteristics of the pathogens of secondary invasive fungal diseases(IFD)in patients with hematological diseases,and the fungal drug resistance,the susceptibility risk factors for secondary invasive fungal infections in patients with hematological diseasesMethodsA retrospective case-controlled analysis was conducted on the medical records of 2,338 cases of infections hospitalized in our department from January 2006 to December 2015.The data were analyzed using SPSS 19.0 statistical software and to study the proportion of fungal diseases in total infections and trends over the past 10 years;analysis of trends in the types and numbers of pathogens,statistics of drug resistance in fungal patients,and the study of the risk factors of secondary invasive fungal disease in patients with hematological diseases..Results1.Among the 2338 infection cases in 10 years,673 invasive fungal cases were diagnosed,among which 16 were proven IFD,50 were probable IFD,138 were possible IFD,and 469 were not identified IFD.The proportion of proven IFD,probable IFD and possible IFD cases from 2006 to 2015 was 15(7.43%),14(6.03%),17(6.25%),and 20(7.04%),respectively.17(6.64%),23(9.91%),27(11.44%),25(10.50%),22(9.24%),and 24(13.56%),suggesting that the proportion of fungal infections in total infections is increasing overall.2.Among the 16 proven IFD cases,7 were Candida tropicalis,3 were Aspergillus,2 were Candida albicans,and there were one case of Candida viscosum,Candida parapsilosis,Candida spp.and Mucor..Of the seven isolated tropical Candida strains,2 strains were resistant to fluconazole,itraconazole,and voriconazole;another strain of T.viscosus was fluconazole,itraconazole,voriconazole,and both sexes.Bacteromycin B were all resistant,1 strain of Candida albicans and 1 strain of Candida glabrata were resistant to itraconazole;the total resistance rate of fluconazole was 23.1%,it was resistant to itraconazole At 30.8%,the resistance rate to voriconazole was 23.1%,and the resistance to amphotericin B was 7.7%.3.In the past 10 years,the isolates were still dominated by Candida albicans,followed by Candida tropicalis,Candida glabrata,Candida krusei,and Aspergillus.The specimen types were mainly sputum specimens,which accounted for 79% of the total specimens,followed by various secretions,accounting for 9%,and the rest were blood(6%),other(puncture,lavage fluid,etc.)and urine.The results of sputum culture are not diagnostic criteria for Candida but have certain clinical significance.4.Statistical analysis of risk factors for secondary invasive fungal disease in patients with hematological diseases,multivariate logistic regression analysis results suggest that age ≥ 70 years,agranulocytosis ≥ 10 days,hospitalization days ≥ 20 days,with diabetes The P value was statistically significant with OR values of 2.707,2.271,2.209,and 2.209,respectively.The P values were 0.01,0.001,<0.001,and 0.032,respectively.It is an independent risk factor for secondary invasive fungal disease in patients with hematological diseases.Conclusions1.The proportion of secondary invasive fungal diseases in patients with hematological diseases is increasing as a whole,and the incidence of invasive candidiasis is decreasing.2.Candidaemia was mainly caused by Candida tropicalis;another analysis of drug resistance suggested that fluconazole,itraconazole,and voriconazole were all resistant strains.3.Age≥ 70 years old,diabetes mellitus,hospitalization days ≥ 20 days,agranulocytosis ≥ 10 days is an independent risk factor for IFD. |
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