Investigation And Analysis On The Diagnosis And Treatment Of Invasive Fungal Infection In ICU

Objective: Disease characteristics of nosocomial invasive fungal infections(IFIs),the drug resistance ofpathogenic fungi and the treatment and effect of antifungal drugs would be investigated in the intensivecare unit(ICU).We have analysed the rationality of antifungal agents and the risk factors of IFI to set up anIFI risk prediction system,which would be suitable for the hospital in Shihezi city.As thus we provided anreference frame for improving antifungal agents proper clinical utilization.Methods:Retrospective analysis was used to investigate the patient in the intensive care between2012.01and2013.12.We extract the basic information,fungal culture and drug sensitive test,and curative effect ofantifungal agents.Varieties, cost and strength would be analysed between Preemptive therapy group and experiential therapygroup. Those that occur patients with IFI in the ICU Which composed of the diagnosed patients andpatients with were diagnosed clinically risk factors were analyzed. Logistic regression analysis wasperformed using SPSS software, a major independent risk factors were screened out.Result?113cases of IFI were found in546cases with investigation condition of the patients, the incidencerate was20.70%, of which7cases were diagnosed,71cases of clinical diagnosis,35suspected cases.Theisolated61strains, including49strains of Candida albicans (80.33%), Candida tropicalis (9.84%),6strains of Candida glabrata2strains (3.28%), Candida parapsilosis and3strains (4.92%), other1strains ofyeast (1.64%)from the blood, urine, sputum, pleural effusion, wound secretion. Drug sensitive test showedthat the sensitivity of different drugs on fungi has obvious difference. Antifungal agents in the treatmentof107patients,33cases ofempirical treatment of the67cases, preemptive therapy,targeted therapy in7cases. There are four kinds of drugs, fluconazole, voriconazole, amphotericin B, caspofungin be used,84cases in which the drug alone, and23cases of combination therapy. We evaluated the treatment for morethan one week of treatment effect in patients82cases, total effective rate was40.24%, the crude mortalityrate was25.61%. We analyzed the14risk factors in the IFI infection group and noninfection group,6ofthem had statistical significance.Deep vein catheterization, sepsis, use of broad-spectrum antibiotics?5days, Tumors, mechanical ventilation?3days were5risk factors identified as independentrisk factors, multiple regression analysis.Conclusion: The incidence of IFI was higher in ICU patients, pathogeninfection. IFI has become acommon infectious disease in ICU, but the vast majority of IFI is difficult to diagnose, most patientsreceiving anti-fungal therapy is clinically suspected and diagnosed on the basis of urgent need standardizedtreatment standards. Pathogen infection most commonly Candida albicans sensitivity to amphotericin B isbetter, other commonly used drugs have varying degrees of resistance. IFI's main strategy is empirical drugtreatment and preemptive treatment, fewer choose drugs, treatment needs to be improved. To evaluate theclinical application of antifungal drugs since the proposed evaluation criteria, ICU reasonable applicationof antifungal higher, most drug utilization index DUI>1.0, the results of treatment in line with the trend ofdevelopment. Studies have shown that commonly used drugs DDC large heavy economic burden onpatients.17factors examined risk factors for ICU patients with IFI's more, with the primary disease,complications and invasive treatment, antimicrobial agents and so on. Multivariate Logistic regressionanalysis of five independent risk factors, the conclusion is for reference only. Cope with the diagnosis ofinvasive fungal infections and drug treatment to be studied.