在ICU手术后腹膜炎病例中的真菌流行病学的时间变化
Philippe Montravers1,2,3, Christine Bonnal4, Stefan Andrei5
1Department of Anaesthesiology and Surgical Intensive Care, DMU PARABOL, APHP, Hôpital Bichat, 75018, Paris, France. philippe.montravers@aphp.fr.
概括
在术后腹膜炎 (POP) 患者中,真菌感染正在增加,Candida物种的发病率正在上升. 虽然抗真菌疗法 (AFT) 通常是充足的,但疾病的严重程度影响的结果比AFT本身更大.
科学领域:
- 医学真菌学 医学真菌学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 在重症监护机构中,真菌感染越来越令人担忧.
- 关于术后周周炎 (POP) 中真菌发病率的数据有限.
研究的目的:
- 研究POP患者的真菌特征的时间变化.
- 评估抗真菌疗法 (AFT) 的充分性和POP患者的预后.
主要方法:
- 从1999年至2019年,对患有POP的ICU患者进行了回顾性单心分析.
- 评估真菌培养,AFT和临床结果.
主要成果:
- 随着时间的推移,POP中的真菌患病率显著增加 (p < 0.01),Candida albicans和non-albicans的患病率上升.
- 在50%的真菌病例中获得了足够的经验性AFT; 94%的受试者获得了记录的AFT,主要是可纳.
- 虽然死亡率相似,但真菌感染导致了更长的机械通风和ICU停留.
结论:
- 在POP中观察到高且不断增加的真菌比例,包括Candida物种.
- 卡斯波丁显示出足够的AFT,而可纳适合缓和升级.
- 在ICU患有POP的患者中,疾病严重程度是临床结果的主要驱动因素,而不是AFT充分性.
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