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題 名 | 念珠菌菌血症的治療成效與死亡危險因子分析=The Outcome and Mortality Risk Factors in Patients with Candidemia |
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作 者 | 方喬玲; 吳淑娟; 陳立奇; | 書刊名 | 北市醫學雜誌 |
卷 期 | 16:1 2019.03[民108.03] |
頁 次 | 頁67-74 |
分類號 | 415.15 |
關鍵詞 | 念珠菌菌血症; 抗黴菌藥品; 危險因子; Antifungal agent; Candidemia; Mortality; |
語 文 | 中文(Chinese) |
中文摘要 | 目的:本文旨在探討念珠菌菌血症病人治療之處方模式、感染念珠菌菌血症之死亡率及影響死亡的危險因子。方法:回溯2014年1月至2016年12月間確診為念珠菌菌血症成年病人之資料進行分析,觀察治療後最終的死亡率。結果:共收納60位病人,平均年齡71.213.5歲,念珠菌菌血症的感染菌種以非白念珠菌居多(58.3%),血液中已無念珠菌時,持續治療14天以上者死亡率較低(p=0.0009),伴有敗血性休克(0.001)、惡性腫瘤病史(p=0.015)、75歲以上(p=0.021)、曾使用廣效性抗生素(P=0.009)為死亡相關的獨立危險因子,整體死亡率為40%。Fluconazole、Caspofungin、Lipo-Amphotericin B投予適當劑量的比率為85.5%、53%、100%。結論:念珠菌菌血症死亡率高,對於高風險的病人,及早投與適當的藥品與劑量,血液培養陰性後再治療14天,可降低死亡率。 |
英文摘要 | Objective: This study aimed to explore the prescription model and mortality rate of Candidemia, and risk factors that affect the mortality rate of Candidemia. Methods: Data of mortality after treatment among adult patients confirmed with Candidemia between January 2014 and December 2016 were traced and analyzed retrospectively. Results: Sixty patients with an average age of 71.2 13.5 years were enrolled in this study. Non-albicans Candida is most common species of infection in our hospital. The all-cause mortality rate was 40%. Multivariate analysis on the all-cause mortality showed that patients treated 2 weeks continuously had lower mortality (P=0.0009), while septic shock (P=0.001), a disease history of malignancy (P=0.015), older than 75 years (P=0.021), and prior exposure to broad-spectrum antibiotics (P=0.009) were independent risk factors of mortality. The rate of proper dose of Fluconazole, Caspofungin, and Lipo-Amphotericin B were 85.5%, 53%, and 100%. Conclusion: The mortality rate of candidemia was high. Early drug intervention with proper dosage and additional 14 days treatment after negative results in blood culture reduced the mortality. |
本系統中英文摘要資訊取自各篇刊載內容。