摘要
Abstract
Objective To investigate the pathogenic distribution,drug sensitivity analysis and susceptibility factors of inva-sive fungal disease(IFD)in emergency patients with severe illness,in order to provide scientific basis for clinical treatment and hospital sensitivity monitoring of patients with severe illness.Methods A total of 272 critically ill patients in the emer-gency department of the First Affiliated Hospital of PLA Air Force Medical University from January 2018 to January 2023 were retrospectively included,and divided into observation group(n=136)and control group(n=136)according to whether fungal infection occurred.The strain distribution and drug susceptibility analysis of fungal infection in the observation group were statistically analyzed.Clinical data of patients in the two groups were collected and compared.The accuracy of the pre-dictors was assessed according to the receiver operating characteristic curve(ROC).Results A total of 136 pathogenic fun-gal strains were detected in the observation group,mainly Candida albicans.The results of drug susceptibility analysis were consistent with clinical experience.Logistic multivariate analysis showed that body mass(OR=0.171),age(OR=1.118),length of hospital stay(OR=1.293),duration of mechanical ventilation(OR=2.116),indignant catheter(OR=0.329),admission blood glucose(OR=1.652),C-reactive protein(OR=2.321),peritoneal dialysis(OR=0.081)were independent risk factors for IFD in emergency critically ill patients(P＜0.05).ROC curve analysis showed that the area under curve(AUC)for joint prediction and evaluation of secondary IFD in critically ill patients was 0.951,95％CI was 0.916-0.987,sensitivity was 0.873,and specificity was 0.948.Compared with Az=0.5,the difference was statistically significant(P＜0.05).Conclusion Candida albicans is the main pathogen causing fungal infection in emergency critically ill patients.The results of drug sensitivity analysis were consistent with clinical experience.Body weight,age,hospital stay,mechanical ven-tilation time,indignant urinary tube,admission blood glucose,C-reactive protein and peritoneal dialysis were independent risk factors for IFD in emergency critically ill patients.关键词
急诊/危重症患者/真菌感染/真菌分布/药敏分析/易感因素Key words
emergency/critically ill patients/fungal infection/fungal distribution/drug sensitivity analysis/predisposing factor分类
医药卫生
