查詢結果分析
相關文獻
- Clinical Evaluation of Nosocomial Fungal Urinary Tract Infections in a Medical Intensive Care Unit
- 新生兒加護病房的院內感染
- 院內感染與早產兒
- 冠狀動脈繞道手術之手術部位感染危險因子之探討
- 一區域醫院1995至1997年院內感染資料分析
- 醫院內感染和空調
- Acinetobacter Baumannii院內感染之介紹
- Nosocomial Klebsiella pneumoniae Bacteremia: Clinical Features and Antimicrobial Susceptibilities of Isolates
- Nosocomial Gram-Negative Bacteremia in Critically Ill Patients: Epidemiologic Characteristics and Prognostic Factors in 147 Episodes
- 某醫學中心各加護中心院內感染金黃色葡萄球菌之調查
頁籤選單縮合
題名 | Clinical Evaluation of Nosocomial Fungal Urinary Tract Infections in a Medical Intensive Care Unit=內科加護病房院內黴菌泌尿道感染之臨床評估 |
---|---|
作者姓名(中文) | 余文良; 鍾錫裕; | 書刊名 | 中國醫藥雜誌 |
卷期 | 2:4 1997.12[民86.12] |
頁次 | 頁220-226 |
分類號 | 419.38 |
關鍵詞 | 院內感染; 黴菌菌尿症; 抗黴菌療法; Nosocomial infection; Funguria; Antifungal therapy; |
語文 | 英文(English) |
中文摘要 | 加護病房之住院病人其院內黴菌泌尿道感染率正逐漸升高。院內黴菌泌尿道感染之治療與預後目前並未完全確立。本文為某醫院內科加護病房1994年至1995年,30位院內黴菌泌尿道感染病人之迴溯性調查與分析。病人有13位女性和17位男性,平均年齡66歲(範圍,19-96歲)。最常見之致病黴菌是Canaiaa albicans佔47﹪(14/30),其他依序為未進一步鑑定之酵母菌類病菌佔37﹪(11/30)、Canaiaa tropiocalis佔10﹪(3/30)、Canaiaa humicola佔3﹪(1/30)、及Tricosporum cutaenum佔3﹪(1/30)。已鑑定之黴菌其治療率為53﹪(10/19):未進一步鑑定之酵母菌類病菌其治療率為18﹪(2/11),兩者俱統計學上之差異(p<0.05)。22位病人完成尿液培養之追蹤。整體而言,抗黴菌治療之尿液黴菌根除率為5﹪(4/8),而未治療者之自然根除率為7﹪(1/14),兩者俱統計學上的異(p<0.05)。所有病人之死亡率為47﹪(14/30)。病人接受抗黴菌治療與否其存活率並統計學上之差別。病人疾病嚴重程度4分以上或合併全身性系統性黴菌感染者其死亡率明顯昇高。持續出現黴菌菌尿症之死亡率為47﹪(8/17),而黴菌菌尿症根除者之死亡率為40﹪(2/5),兩者亦無統計學上之差異(p<0.05)。結論是抗菌療法可有效的根除黴菌菌尿,但對預後無顯著影響:病人出現持續性黴菌菌尿症並不一定伴隨高死亡率,但必須確認其中屬於病情嚴重度高者或全身系統性黴菌感染者,加以積極治療,以期減少死亡率。 |
英文摘要 | The incidence of nosocomial fungal urinary tract infections (UTIs) among patients hospitalized in a critical care setting is on the rise. The treatment, and clinical outcome of nosocomial fungal UTIs are not well established in the literature. The records of 30 patients with nosocomial fungal UTIs, hospitalized in a medical intensive care unit (MICU) from January 1994 through December 1995, were retrospectively reviewed. The patients consisted of 13 women and 17 men with a mean age of 66 years ( range. 19-96 years). Candida albicuns was the most common organism isolated from urine cultures (47%), followed by an unidentified yeast-like organism (37%), Candida tropicalis (10 %), Candida humicola (3%), and Tricosporum cutaneum (3 %). Species of identified fungal pathogen were treated in 53% (10/19) of the patients, and the unidentified yeast-like organism in 18% (2/11) (p< 0.05). Twenty-two (73%) patients had follow-up urine cultures. The eradication rate was 50% (4/8) in the treated group and 7% (1/14) in untreated group (p<0.05). The overall case-fatality rate was 47 % ( 14/30). Although the difference was not statistically significant, patients who received antifungal therapy showed a higher survival rate compared to patients who did not (67% vs 44%, p>0.05). The case-fatality rate of patients with persistent funguria was 47% (8/17) and 40% (2/5) for those without (p> 0.05). Higher severity score and systemic fungal infection were associated with higher mortality rates (p=0.018 and p= 0.14 respectively). The main prognostic factors affecting the clinical outcomes of nosocomial fungal UTIs in the MICU are a high severity score and systemic fungal infection. Antifungal therapy could significantly eradicate funguria, but it does not significantly influence the survival rate. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。