The Retrospective Analysis Of Deep Fungal Infections Of Inpatients In An A-grade Hospital

Background Deep fungal disease,also known as invasive fungal infections(IFIs),is one of the major infectious diseases that threaten human health.In recent years,the incidence of deep fungal disease is on the rise,especially in hospitalized patients.According to statistics,from 1980 to 1990,the number of hospital acquired fungal infections rose from 2 ‰ to 3.8 ‰ in Ameirican.Pathogenic fungi caused by deep fungal disease are mostly opportunistic pathogens,mainly include Candida,Aspergillus,Cryptococcus and so on.Among them,the most common is Candida albicans,the United States hospital infection monitoring data show that during 1992-1999,Candida albicans accounted for fungal infections caused by nosocomial infection in the first place,accounting for all hospital bloodstream infection pathogens fourth place.The rise of deep mycosis in the hospital is associated with an increased susceptibility to deep mycosis.Deep fungal diseases occur mostly in immunocompromised patients and are particularly common in AIDS,blood diseases,malignancies,organ transplants and burns.Deep fungi can affect all body tissues and systems,of which respiratory infections are the most common.Deep fungal disease in the hospital often for some critically ill patients with co-infection,the early clinical symptoms easily covered by the primary disease,diagnosis must rely on fungal culture and pathological examination,which is not conducive to early diagnosis and treatment,so the high mortality This has drawn increasing attention from the medical community.In recent years,research on deep fungal infections in hospitals has been more and more reported,but the research on the incidence of deep fungi in the our hospital in recent years has not been reported yet.Objective By referring to the case data of inpatients in the past 3 years in our hospital,this paper aims to understand the deep fungal infection and treatment status of inpatients in our hospital and provide the basis for the prevention and treatment of deep fungal infection.Methods According to the data of inpatients in our hospital from July 2014 to June 2017,the basic information and clinical data of patients were extracted and analyzed according to the design of the preliminary questionnaire.Results From July 2014 to June 2017,972 cases of deep fungal disease were detected in hospitalized patients in our hospital.Among them,573(59.0%)were male,399(41.0%)were female,and the ratio of male to female was 1.44: 1.Deep fungal infections occurred mainly in patients over the age of 60,accounting for 60.80% of patients with deep fungal infections;Department of Critical Care Medicine for the occurrence of deep fungal infections most departments,accounting for 13.99%,followed by respiratory medicine and intensive care unit(ICU),respectively 11.93% and 11.21% respectively.The major sites of deep fungal infection were respiratory system(48.66%),followed by urinary system(28.91%).The positive rate of sputum in the specimens was the highest(47.33%),Candida albicans(44.44%)was the main pathogen of deep fungal infection in patients.Pathogenic bacteria were the most sensitive to amphotericin B(99.69%)and the highest to itraconazole(5.76%).The main risk factors for deep fungal infection in our hospital are broad-spectrum antibiotics,glucocorticoids,immunosuppressive agents and invasive procedures.The clinical use of antifungal drugs is mainly triazole.In our study,there were 665 patients receiving antifungal therapy,Among them,637(95.79%)patients were treated with at least one triazole antifungal agent,predominately fluconazole and voriconazole,most of the patients after antifungal therapy had good prognosis,effective rate + improvement rate75.74%.Conclusion 1.Patients aged> 60 years,chronic lung disease,diabetes,cancer and long-term use of antibiotics,glucocorticoid patients are the main population of deep fungal infections in our hospital;2.Deep fungal infections in multiple departments for the Department of Critical Care Medicine,Respiratory and ICU,the above departments should pay attention to the prevention and control of fungal infections;3.Deep fungal infection can affect the body organs and systems to the respiratory system,urinary tract infection and bloodstream infections are most common;4.Candida albicans is the main pathogenic fungus infection in our hospital,followed by Candida glabrata and Candida tropicalis.Drug susceptibility results show that the deep fungal infection in our hospital is the most sensitive to amphotericin B,the highest resistance to itraconazole;6.Deep fungal infection in our hospital use the most triazole antifungal drugs,antifungal therapy prognosis patients generally better.