Turkey一项9年的医院内儿童念珠菌感染的调查研究

David

Original article
Nosocomial candidaemia in children: results of a 9-year study

Solmaz Celebi11Department of Pediatrics, Division of Pediatric Infectious Diseases, Uludag University Medical Faculty, Bursa, Turkey, Mustafa Hacimustafaoglu11Department of Pediatrics, Division of Pediatric Infectious Diseases, Uludag University Medical Faculty, Bursa, Turkey, Ozlem Ozdemir11Department of Pediatrics, Division of Pediatric Infectious Diseases, Uludag University Medical Faculty, Bursa, Turkey and Guven Ozkaya22Department of Biostatistics, Uludag University Medical Faculty, Bursa, Turkey1Department of Pediatrics, Division of Pediatric Infectious Diseases, Uludag University Medical Faculty, Bursa, Turkey and 2Department of Biostatistics, Uludag University Medical Faculty, Bursa, Turkey
Solmaz Celebi, MD, Department of Pediatrics, Division of Pediatric Infectious Diseases, Uludag University Medical Faculty, 16059 Gorukle, Bursa, Turkey. Tel./Fax: +90 224 295 0000.
E-mail: solmaz@uludag.edu.tr
Summary

The aim of this study was to determine changes in the incidence of nosocomial candidaemia and to evaluate the risk factors, demographic features, treatment and clinical outcome associated with candidaemia in a Turkish tertiary care paediatric unit within a 9-year period. The data of children who were diagnosed as nosocomial candidaemia, were examined in this study. Between January 1997 and December 2005, a total of 102 nosocomial candidaemia episodes were identified in 102 patients. The rate of nosocomial candidaemia in our clinic increased from 3.2 cases per 1000 admissions in 1997–1999, to 5.5 per 1000 admissions in 2000–2002 and to 6.9 per 1000 admissions in 2003–2005 (P = 0.003). The species most frequently causing candidaemia were Candida albicans (39.2%), Candida parapsilosis (21.6%) and Candida tropicalis (15.7%). The mortality of C. albicans (37.5%), was significantly higher than the mortality of non-albicans species (17.7%) (P = 0.04). Independent risk factors associated with candidaemia-related deaths by logistic regression analysis were disseminated candidiasis (odds ratio, 5.7; P = 0.01), paediatric intensive care unit stay (odds ratio, 8.1; P = 0.001), prolonged antibiotics therapy (odds ratio, 5.2; P = 0.014), use of total parenteral nutrition (odds ratio, 4.4; P = 0.038) and mechanical ventilation (odds ratio, 4.9; P = 0.01). The rate of nosocomial candidaemia in our clinic increased >2-fold during the study period.

桂花香

谢谢！
念珠菌血症相关死亡的独立危险因素是：播散性念珠菌病，住儿童ICU，长期抗生素治疗，胃肠外营养和机械通气。........

David

The aim of this study was to determine changes in the incidence of nosocomial candidaemia and to evaluate the risk factors, demographic features, treatment and clinical outcome associated with candidaemia in a Turkish tertiary care paediatric unit within a 9-year period. ( 本研究对土耳其一家儿童医院长达9年的研究，目的在于发现医院内念珠菌血症的变化以及评估风险因素，地区特征，临床治疗结果。)The data of children who were diagnosed as nosocomial candidaemia, were examined in this study. （研究分析了医院内诊断有念珠菌血症儿童的数据。）Between January 1997 and December 2005, a total of 102 nosocomial candidaemia episodes were identified in 102 patients. （在1997年1月至2005年12月，总计102个病人诊断出医院获得性念珠菌血症。）The rate of nosocomial candidaemia in our clinic increased from 3.2 cases per 1000 admissions in 1997–1999, to 5.5 per 1000 admissions in 2000–2002 and to 6.9 per 1000 admissions in 2003–2005 (P = 0.003).（患病率持续增加，从1997-1999的每1000住院数3.2个病例，到2000-2002年的5.5，再到2003-2005年的6.9） The species most frequently causing candidaemia were Candida albicans (39.2%), Candida parapsilosis (21.6%) and Candida tropicalis (15.7%).(最常见引起念珠菌血症的致病菌分别是白色念珠菌39.2%，近平滑念珠菌21.6%，热带念珠菌15.7%) The mortality of C. albicans (37.5%), was significantly higher than the mortality of non-albicans species (17.7%) (P = 0.04). （白念的致死率37.5%显著高于非白念17.7%）Independent risk factors associated with candidaemia-related deaths by logistic regression analysis were disseminated candidiasis (odds ratio, 5.7; P = 0.01), paediatric intensive care unit stay (odds ratio, 8.1; P = 0.001), prolonged antibiotics therapy (odds ratio, 5.2; P = 0.014), use of total parenteral nutrition (odds ratio, 4.4; P = 0.038) and mechanical ventilation (odds ratio, 4.9; P = 0.01).(与念珠菌血症相关的死亡独立危险因素是：播散性念珠菌病，住儿童ICU，长期抗生素治疗，胃肠外营养和机械通气) The rate of nosocomial candidaemia in our clinic increased >2-fold during the study period.（在研究中发现医院获得性念珠菌血症的发病率增加了2倍。）

怡之秋

在研究中发现医院获得性念珠菌血症的发病率增加了2倍  抗生素不合理运用的现实这样的问题实在是一言难尽。。。谢谢老师。